Getting a cancer diagnosis at any age is derailing. But when you’re diagnosed with cancer during your child-bearing years, it can force you to put plans to start a family on hold. It can also force you to consider whether you want kids in the future, since cancer treatments can lead to infertility. Luckily, there are ways to preserve your fertility before beginning treatment.
“When people of child-bearing age are diagnosed with cancer, we automatically talk to them about fertility preservation,” says Monique Swain, M.D., an obstetrics and gynecology surgeon with Henry Ford Health. “We ask if they’re interested in having children and discuss their options with them. People are having children older and older now, so we always offer this discussion.”
Cancer Treatments That Can Affect Fertility
Cancer itself doesn’t make someone infertile—it’s certain cancer treatments that lead to infertility, depending upon where the cancer is and the treatment received. For example:
- If part of your reproductive system (such as the testicles, prostate, ovaries, uterus or cervix) is directly affected by cancer and must be altered by surgery or radiation, this is called regional therapy—meaning it is localized to one area of the body—and your fertility can be impaired. Having surgery or radiation in the abdomen or pelvis region can also affect fertility.
- If you receive chemotherapy, this is called systemic therapy—meaning it affects your entire body—and your fertility can be impaired. “Chemotherapy works by attacking actively dividing cells, including the ovaries and testicles,” explains Dr. Swain. “This can cause ovary and testicle disfunction and fertility concerns.”
However, if you receive regional therapy in an area that doesn’t affect your reproductive system, this won’t affect fertility because the treatment is confined to the area of the tumor.
There is one catch: radiation to the brain can damage areas that control hormone production, affecting fertility. “But no matter what type of cancer you are diagnosed with, it’s best to talk to your doctor about whether you need to consider fertility preservation,” says Dr. Swain.
Fertility Preservation Options
“While there are a few different fertility preservation options, the gold standard is cryopreservation—freezing eggs and sperm to save for later,” says Ali Dabaja, M.D., a urologist and male infertility specialist with Henry Ford Health. Other options for women (though they aren’t as effective as cryopreservation and are not the standard of care) include:
- Ovarian protection agents. Ovarian protection agents temporarily shut down the ovaries so that they’re less likely to be attacked during chemotherapy. However, this is still experimental. “There have been two studies looking at these ovarian protection agents, but in both studies, they found that ovary protection agents didn’t improved someone’s chances of getting pregnant, it only improved their chances of getting their period back and getting it back sooner,” says Dr. Swain.
- Oophoropexy. Oophoropexy aims to protect the ovaries during radiation by stretching them out of the radiation area, so that they won’t be attacked during treatment. This option, however, is also still experimental and not foolproof.
When It’s Safe To Have A Baby After Cancer
After completing treatment, you should talk to your doctor to see when it is safe to try to conceive. For men, Dr. Dabaja says it is usually recommended to wait at least 12 months after completing chemotherapy. For women, waiting a year or two is generally the rule of thumb. (Don't worry--previous treatments will not affect a fetus or a future pregnancy.)
“I work with breast cancer patients, and for them, I typically recommend waiting two years after remission to conceive,” says Dr. Swain. “This is because the highest risk of recurrence is within the first two years.”
Age, however, is also a factor. “If someone is older and they don’t have time to wait two years, it’s okay to consider getting pregnant a year after completing treatment,” says Dr. Swain. “That’s something to discuss with your medical oncologist—sometimes you don’t have two years to wait.”
To make an appointment with a cancer specialist, visit henryford.com/cancer or call 1-888-777-4167.
Talk to your oncologist about how your fertility may be affected by cancer treatments. If necessary, they can refer you to The Henry Ford Center for Reproductive Medicine, where cancer fertility specialists can guide you through fertility preservation options.
Dr. Monique Swain is an obstetrics and gynecology surgeon who specializes in women at high risk for breast cancer. She sees patients at Henry Ford Medical Center -- New Center One in Detroit and Henry Ford West Bloomfield Hospital.
Dr. Ali Dabaja is a urologist and male infertility specialist who sees patients at Henry Ford Medical Centers in Dearborn and Sterling Heights, Henry Ford Reproductive Medicine in Troy, and Henry Ford Hospital in Detroit and West Bloomfield.