Information for women seeking to build families post-cancer therapy.
The first course of action is to test for fertility, and then determine if assisted reproductive technology treatments are needed and what options are available.
Testing fertility
Many women will resume regular menstrual periods after treatment. However, this does not necessarily indicate that they are fertile. The most reliable way to assess fertility after cancer therapy is by measuring hormone levels in the blood (follicle stimulating hormone, estradiol, and progesterone levels timed to specific phases of the menstrual cycle). An ultrasound of the ovaries can also be useful to approximate fertility potential.
What are the options?
Fertility Treatment and Assisted Reproduction
Ideal option for women who are infertile or determined to have diminished fertility after cancer treatment
Depending on the nature of the infertility, conventional methods of infertility treatment such as in vitro fertilization can be very successful.
Third-Party Reproduction Egg Donation
Ideal option for women who are menopausal after cancer treatment
Egg donation is very clearly the most successful fertility procedure that is available today. Women who are infertile or in menopause can still carry a pregnancy using eggs from an anonymous or known donor. In women with male partners, donor eggs can be fertilized with the male partner’s sperm to create embryos that are genetically related to the male partner. In same-sex relationships, donor eggs can be fertilized with donor sperm. Some lesbian couples may elect to have the cancer survivor’s female partner serve as the egg donor.
Gestational Surrogacy
Ideal option for women for whom carrying a pregnancy is not considered to be safe
Gestational surrogacy refers to a treatment process in which another woman (gestational surrogate) undergoes the embryo transfer process and carries the pregnancy to term. The intended parents are involved with the pregnancy, are typically present at the birth, and take over parenting responsibilities immediately thereafter. In same-sex relationships, the female partner for whom carrying a pregnancy is considered to be safe can serve as the gestational surrogate for the female partner for whom carrying a pregnancy is not considered to be safe.
Safety of pregnancy after cancer
Thus far, research on the safety of pregnancy after cancer is reassuring. Further research is necessary to confirm these findings.
Mothers: To date, research suggests that pregnancy after cancer does not trigger recurrence, even after breast cancer (10).
Children: The risk of birth defects in children born to cancer survivors is reported to be similar to that of the general public: approximately 2-3% (10).
Children born to cancer survivors do not appear to be at increased risk for getting cancer themselves (except in true inheritable cancer syndromes) (11).