Ways to preserve your fertility
There are options available for women to preserve their fertility. Your doctor should discuss this with you and the fertility clinic or assisted conception unit.
It's important to understand that these methods are not always successful or suitable for everyone.
The possible options for preserving fertility include:
- freezing embryos
- freezing eggs
- freezing ovarian tissue
If you choose to do so, these must be done before starting chemotherapy.
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 is not always successful. 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
You can have a small operation to remove some ovarian tissue, which is then frozen. This is called ovarian tissue cryopreservation. The tissue is put back once your cancer treatment has finished.
If the ovarian tissue then starts working normally, the ovaries may produce eggs and so you remain fertile.
This is a new treatment that is still in development.
The number of cryopreservation services are increasing across the UK. Ask your specialist if this is suitable for you and whether they can refer you to one of these services.
Ovarian stimulation and possible risks
Ovarian stimulation is not suitable for everyone. It takes at least 2 weeks to stimulate the ovaries. If you need to start chemotherapy straight away, there may not be time for you to have it.
The drugs given to stimulate the ovaries increase the levels of the hormone oestrogen. Oestrogen may encourage some cancers to grow, such as breast cancer.
Your specialist will talk through your options and explain any risks.
In certain cancers your doctor may suggest a 3-4 weekly injection of a Gonadotropin-releasing hormone (GnRH) agonist, such as Zoladex. This is a long acting hormone drug that is used to make a woman go into the menopause for a short time. This is called ovarian suppression.
The hormone drug needs to be given at least a week before chemotherapy starts. It will stop your ovaries from working and may protect them from the harmful effects of chemotherapy and help to preserve your fertility.
You might experience menopausal symptoms such as hot flushes. This treatment is not suitable for everyone and is not always successful.
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.
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)
These are difficult decisions 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 Human Fertilisation and Embryology Authority (HFEA) website.
Cancer, Fertility and Me is a website for women with cancer who are having treatment that may affect their fertility and chances of becoming pregnant in the future.
It is written by fertility doctors, specialist nurses, psychologists and other professionals.
It aims to help women think about the treatments which may help to preserve their fertility. It also aims to help women prepare to talk with their healthcare professionals, partner, family and friends about fertility preservation before cancer treatment starts.
The Cancer Conversation
The Cancer Conversation is Cancer Research UK's podcast. In the episode exploring infertility and cancer, we chat with people whose cancer journey has had an impact on their fertility.
It also features Professor Richard Anderson, Deputy Director of the University of Edinburgh’s Centre for Reproductive Health. We explore options that are available and what the future of fertility medicine could look like.