While surgery alone does not have an impact on future fertility, the use of additional treatment such as chemotherapy can affect fertility to a significant extent. Studies have shown that even women who resume their periods following completion of chemotherapy may be less fertile and attain menopause earlier.
The effect of chemotherapy on fertility depends on several factors
- Age at which a patient receives chemotherapy,
- Chemotherapy regime used
- The basal egg reserve for that individual.
Dr. Vyjayanthi opines, "some chemotherapy drugs are more damaging to the ovary than others and women with good initial egg reserve and those who are younger do better than those with borderline low egg number or low egg reserve (egg number)".
What are the current fertility preservation options available to women prior to undergoing chemotherapy?
Fertility preservation measures can be discussed with the patient and initiated done before commencing chemotherapy treatment to preserve fertility.
1.Freezing of gametes-egg or embryo is a very simple and commonly employed fertility preservation option available to single women or couples to preserve fertility.
2.For single women oocyte (egg) cryopreservation is an option and for women who are married embryo cryopreservation is a better alternative.
Both these treatments involve undergoing the process of ovarian stimulation with hormone medication to collect eggs which can then be frozen for future use-egg freezing and in the embryo cryopreservation option, post egg collection the couple undergo IVF (In Vitro Fertilization) process and embryos are created which are then frozen for future use.
The other fertility preservation option which is available which can be offered only in select fertility centers as it needs high technical expertise is ovarian tissue cryopreservation. The women undergo laparoscopy (keyhole surgery) to obtain ovarian tissue which is then frozen and can be reimplanted later to restore ovarian function.
Does hormone treatment given for breast cancer affect future fertility?
Hormone treatment per se does not affect fertility but the duration of treatment lasting for a few years at an age when pregnancy is not advisable can compromise fertility.
Scientific evidence has that women who become pregnant after getting treated for breast cancer are less likely to suffer from a recurrence or die of the disease than women who do not get pregnant.
How long one should wait after treatment of breast cancer before attempting pregnancy?
It is ideal to wait for a few years to get through the early risk of recurrence and in women needing hormone therapy, one should wait till the hormone therapy is over.
Women newly diagnosed with breast cancer are overwhelmed to deal with all issues related to therapy and fertility issues are not always adequately addressed.
It is important to discuss fertility issues with patients and refer them to services of fertility specialists so that these young women have the chance to discuss the various fertility preservation options available to them.
Counseling regarding future fertility compromise related to breast cancer treatment and options available to them to preserve fertility will allow these women to make an informed decision regarding their future fertility.
For queries on fertility and breast cancer, contact, Dr. Vyjayanthi at svvyjayanthi99@gmail.com
