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Fertility after cancer treatment

Annually, more than 150,000 Americans are diagnosed with cancer during their reproductive years (younger than age 45). This diagnosis can quickly derail any plans to start a family and in some cases can make it physically impossible to get pregnant. Cancer treatment – surgery, radiation, chemotherapy or hormonal therapy – can directly or indirectly lead to infertility. This means it is extremely important for cancer patients to gather information on fertility preservation prior to receiving treatment.

Lisa Hasty, M.D., a reproductive endocrinologist and infertility specialist at Piedmont Atlanta Hospital, is excited about the technological advances being made in fertility preservation.

Egg freezing is an amazing option for our patients to consider prior to chemotherapy. The success rates have steadily improved over the last five to seven years. We continue to work very closely with our colleagues in oncology as patients are making these decisions.”

How cancer treatment can affect fertility

In women, cancer treatment can affect eggs, hormone levels, or the functioning of the ovaries, uterus or cervix. There is also a risk of developing premature menopause. Multiple factors compound the issue, like age and type of treatment.

The long-term effects of chemotherapy and radiation therapy also depend on the drugs used and the size and location of the radiation field. Many chemotherapy drugs are toxic to the follicles that house the eggs in the ovaries and can interfere or interrupt normal ovulation. This can then lead to premature menopause in young women. Radiation therapy is most damaging when the radiation field is near the ovaries. 

Fertility after cancer

Mirrin Reagan, RN, CNS, WHNP-BC, a nurse practitioner and cancer survivor, encourages women to protect their choices for the future.

“It is our hope and goal that every patient has the ability to resume normal life after treatment. For some this means starting a family and for others it means adding to their family through infertility treatment or exploring the possibility of adoption. Whatever the choice may be, we encourage patients to set goals for a hopeful future.

“Technology has come such a long way,” says Reagan. “Women today are empowered by so many choices. Fertility preservation is a very viable option, so it is important for women to be educated about these options.”

Fertility preservation options

Women can preserve their fertility in one of the following ways:

Embryo cryopreservation - eggs are harvested from ovaries, fertilized through in vitro fertilization, frozen and then stored. This method has the highest chance of success for women.

Egg freezing - unfertilized eggs are frozen for later use.

Gonadal shielding - if radiation is applied to an area far from the pelvis, a shield can be strategically placed to protect reproductive organs from radiation.

Ovarian transposition - if radiation is being applied to the pelvis area, ovaries can be surgically repositioned prior to radiation therapy.

Radical trachelectomy - with early-stage cervical cancer, the surgical removal of the cervix can help preserve a woman's uterus.

Visit Piedmont Women's Services to learn more about reproductive endocrinology.  

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