FERTILITY AND CANCER: AFTER TREATMENT

Common Concerns AFTER Breast Cancer Treatment

After treatment has ended, you may still have some side effects like tiredness, sleeplessness, and anxiety.  These are normal as you are recovering from breast cancer treatment.  You may also be getting back to a regular schedule of work, family, and friends.  Try to give yourself some time to heal and recover from treatment.  Your ability to become pregnant and have a baby may become more important.  Here are a few things to keep in mind:

  • Try to regain your energy and strength by eating well and drinking enough water. Do not try to change too many things at one time.
  • Try to exercise regularly at least three times a week for 30 minutes.
  • If you are sexually active, you will need to continue some form of non-hormonal birth control method after treatment.
  • If you are receiving hormonal therapy (Tamoxifen), you will also need to continue to use some form of non-hormonal birth control method.
  • Talk with your oncology team or fertility doctors about how long you should wait before getting pregnant.

Parenting Options AFTER Treatment

Options to maintain your ability to get pregnant after treatment has ended are limited. This is because damage may have already occurred.  Some women continue to have regular periods, but regular periods may not result in a successful pregnancy.  Research studies show that women can have successful pregnancy after breast cancer treatment.  If you continue to have regular periods or if your periods come back, you may want to consider talking to a reproductive endocrinologist as soon as possible.

  • Some options after treatment if you are not able to become pregnant are surrogacy and adoption.
  • You can get more information about adoption alternatives by contacting local adoption groups or through a national adoption network. Fertile Hope has some information about adoption.
  • You can get more information about surrogacy alternatives by contacting your local or national surrogacy network.
  • The use of donor embryos may not be an option because the hormones (estrogen and progesterone) include used to prepare you should not be used in women with some types of breast cancer.

Risk of Infertility with Breast Cancer Treatment

Many young women with breast cancer have concerns about developing infertility with breast cancer treatment.  They may have received some information about the effects of chemotherapy from their oncology team, other details about infertility from well-meaning friends, and others may not have any information at all.

The risk of not being able to get pregnant is based on a lot of different things: the type of breast cancer treatment and how old you are.  In general, women who receive cyclophosphamide who are over the age of 35 have the highest risk of developing infertility.

To calculate your risk please visit Fertile Hope: Risk Calculator for Women

Fertile Hope: Risk Calculator for Women (search by cancer type or treatment)

 

  • Tamoxifen is an anti-hormonal agent that is used to decrease the risk of recurrence in young women who have not gone through menopause with estrogen receptor (ER+) positive breast cancer.
  • Even when premenopausal women do not have amenorrhea with combination chemotherapy, they may have reduced potential for pregnancy since they must use some form of birth control while on Tamoxifen treatment.
  • Because you take Tamoxifen for at least 5 years, you may go through menopause by the time you finish Tamoxifen therapy.
  • Aromatase inhibitors (AIs) were initially used as first-line hormonal therapy for postmenopausal women with ER+ breast cancer.

 

  • Radiation therapy for breast cancer does not have much effect on your ovaries.
  • Sometimes radiation therapy has an effect on your ability to breastfeed on the side that you received radiation.

Useful Websites:

Breast Cancer.org

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