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Beating the Odds to Have a Baby

In the past, women with cancer were treated without much concern for their future fertility; many were discouraged from even considering pregnancy. But medical advances are now giving cancer survivors more options. Here's an overview:

Does pregnancy increase the odds that cancer will recur?

Current research shows the connection between pregnancy and recurrence is not as strong as once previously believed, even in breast cancers sensitive to hormones. One study even suggests that pregnancy may help ward off cancer. What's more, except for rare hereditary cancers, children of survivors don't have higher rates of birth defects or cancer.

How long should a woman wait after cancer treatment to try to become pregnant?

Though doctors disagree on this waiting period, "the gold standard" is two years because that's when a woman is most likely to have a recurrence, and treating cancer during pregnancy can be hard. Women who need to take drugs like tamoxifen, which can be dangerous to a fetus, must wait until their five-year course of treatment is over. Others need time for surgical healing. The basic rule is that a woman should talk to her physician to make a decision.

How does cancer affect fertility?

In most cases it's the treatment rather than the cancer itself that can affect fertility. Ovarian or uterine cancers, for example, may require surgery to remove reproductive organs or radiation to the abdominal area that can destroy a woman's eggs (unlike a man's sperm, new eggs can't be produced). Many chemotherapy regimens reduce the number of eggs and can send women into early menopause. Unfortunately, doctors can't predict who will retain fertility and who won't. Even if a woman remains fertile, chemotherapy may affect the heart or liver, which could make a pregnancy high risk. And pregnancy and childbirth might damage surgical repairs done to organs like the bowel and rectum.

What can a woman with cancer do to preserve her fertility?

The Ethics Committee of the American Society for Reproductive Medicine just released a report stating that doctors should offer only the proven fertility treatments of sperm and embryo freezing to cancer patients. Other methods, such as freezing of eggs and ovarian tissue are considered experimental and should only be done at research hospitals. Doctors are also developing techniques such as ovary transplantation and inducing temporary ovarian "hibernation."

Women should ask about their options and seek a second opinion if necessary. Sometimes, for example, doctors can use chemotherapy that is less toxic to the ovaries, or can reposition the ovaries before radiation. The key is asking immediately, since treatment begins soon after diagnosis. Visit Fertile Hope to learn more.