It's not as easy for women to keep their fertility as it is for men. But there are ways to do it.
Possible ways to keep your fertility include:
- freezing embryos
- freezing eggs
- freezing ovarian tissue
If you choose to do so, these must be done before starting chemotherapy.
Unfortunately there can be problems with these methods and they are not suitable for everyone.
You have fertility drugs to stimulate your ovaries to produce eggs. Doctors can then collect (harvest) the eggs and use your partner’s sperm to fertilise them in a laboratory, creating embryos. They then freeze the embryos until you want to have a baby, when the embryo is returned to your womb to grow there. This is called in vitro fertilisation (IVF).
It’s quite a complicated process and it doesn’t always succeed. It is important to understand that the embryos are the joint property of you and your partner. Both of you will need to agree to use them later.
You may not have a partner at the moment. You can have just your eggs frozen until you’re ready to have a baby.
The process is very similar to IVF. You have drugs to stimulate your ovaries to make eggs. Doctors then collect and freeze them until you are ready for them to be fertilised.
Freezing ovarian tissue
Researchers are looking into removing ovarian tissue and freezing it before chemotherapy starts. The idea is to put the ovarian tissue back after treatment ends.
If the ovarian tissue then starts working normally, the ovaries may produce eggs and so you remain fertile.
At the moment there are only a few centres in the UK offering this service. Talk to your doctor if you want to know more about this.
Possible problems with freezing embryos and eggs
To freeze embryos and eggs, you start by having drugs to stimulate your ovaries so that the doctor can collect your eggs.
There are two possible problems with this.
Firstly, it more difficult to have this type of treatment with some types of cancer. One example is a hormone dependent breast cancer. Your specialist will need to discuss what fertility drugs you can have.
Secondly, it can take a few weeks to stimulate your ovaries and collect the eggs. Your specialist may not want you to wait to start your chemotherapy for that long. But it depends on when you had your last period. It may take as little as two weeks, so it’s definitely worth asking if this is possible for you.
The success rate for IVF depends on your age. The younger the woman is the more successful IVF is.
The success rate of embryo freezing is increasing. The younger the woman is the more successful it is.
Only 60 babies have been born in the UK using the woman's own frozen eggs since 2001. Newer methods of storing eggs may help to improve the success rate. But at the moment it isn’t clear how successful this approach is for women with cancer.
Freezing ovarian tissue
Around 60 babies have been born worldwide after freezing ovarian tissue. It's still too early to tell if the technique will work well enough to be made more widely available. But so far the results look promising.
Getting pregnant after chemotherapy
Most doctors will advise women that it’s best to wait 2 years after chemotherapy treatment before becoming pregnant.
This is not because the pregnancy could affect the cancer. It’s because if your cancer was going to come back, it would be most likely to do so within two years. You would then need more treatment – and this would be very difficult if you were pregnant or had a young baby.
There’s no evidence that pregnancy increases the risk of breast cancer or melanoma coming back. So don’t worry if you’ve heard that pregnancy hormones can affect these cancers.
Other fertility options
There are other options you could consider if cancer has affected your fertility:
- using donor eggs
- using donated sperm so doctors can freeze embryos rather than eggs
- using donated embryos
- surrogacy (when another woman carries the baby for you)
There are a lot of complex issues to think about with these choices. And some options may not be straightforward. For example, some of them aren’t always funded by the NHS. There is also a shortage of donors.
You can discuss these options with your fertility expert. Many people find it helpful talking to a counsellor about all the issues involved.
You can also read more about these fertility treatments on the the Human Fertilisation and Embryology Authority (HFEA) website.