Cancer and Fertility: What You Should Know
Mar 02, 2020 Cedars-Sinai Staff
Getting the news that you have cancer comes with a range of worries, fears, and questions. For women, understanding how cancer treatment might affect your fertility is an important concern to discuss with your doctor.
Common misconceptions about cancer and fertility
Dr. Erica Wang, reproductive endocrinology and infertility specialist at Cedars-Sinai, focuses on fertility preservation for women who have been diagnosed with cancer. Dr. Wang says there are two common misconceptions about fertility and cancer.
"Sometimes, patients don't know that their cancer treatments, such as chemotherapy, can have a negative effect on their fertility," Dr. Wang says. "Some women might also think that, because they have cancer, they are never going to get pregnant in the future."
Cancer treatment can decrease fertility, Dr. Wang says, but there are also ways that specialists can help cancer patients preserve their chances of getting pregnant in the future.
How cancer treatment can affect fertility
For women diagnosed with cancer, the impact of cancer on their fertility depends on the types of treatments they undergo.
Dr. Wang says that not all chemotherapy treatments have the same effect on fertility. Some chemotherapy agents, such as alkylating agents, are harder on the ovaries and deplete the resting pool of eggs.
Other factors that impact fertility for women with cancer
Age is another factor in how cancer treatment can impact fertility.
"Typically, the younger you are when you are diagnosed with cancer, the better your chances are for restoring fertility after treatment," Dr. Wang says. "Just like for women who don't have cancer, the younger you are the easier it is to conceive."
For women with breast cancer who are diagnosed between ages 35-40, there's about a 50% chance of getting your period back after chemo, while breast cancer patients over age 40 have a less than 50% chance of getting their period back after chemo.
Questions to ask about fertility if you are diagnosed with cancer
If you are a woman who was recently diagnosed with cancer, Dr. Wang says the most important thing is to consult with a fertility specialist before undergoing treatment.
Dr. Wang says women diagnosed with cancer should ask their OB-GYN or oncologist questions such as:
- Is this type of cancer treatment going to affect my fertility?
- If there is surgery involved in my treatment, will it impact my fertility or my ability to carry a pregnancy in the future?
- What kind of treatment options are available to preserve my fertility?
Fertility preservation options
Dr. Wang says that if cancer patients are considering having children in the future, she recommends fertility preservation.
Regardless of what type of cancer a woman might have, there are two main types of fertility preservation methods: egg freezing and embryo freezing.
Egg freezing involves having a woman's eggs extracted, frozen, and stored in order to preserve the eggs' reproductive potential. With embryo freezing, a woman's eggs are fertilized with sperm before they are frozen for future use.
Knowing your fertility options
Dr. Wang says one of her primary concerns is that women diagnosed with cancer are educated about their risk of infertility and fertility options, so that they can make an informed choice about their care.
"What I've heard from patients who are the most upset, or have the most regret, is that no one told them about their fertility options prior to their cancer treatment," Dr. Wang says.
"The most important thing is that women diagnosed with cancer are counseled and have an opportunity to make a decision, as opposed to a doctor making a decision for them."
New bill that eliminates payment obstacles for fertility preservation
In October 2019, the state of California passed Senate Bill 600, which requires health insurance companies to cover the cost of fertility procedures for patients undergoing treatment that can make it difficult to have children.
"This has been a significant financial barrier for some of our patients, as a lot of insurance companies wouldn't pay for egg freezing or embryo freezing," Dr. Wang says.