Fertility Issues to Discuss Before You Start Treatment

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Most doctors consider treating breast cancer more important than fertility issues. But you may not have to choose one or the other. Many women successfully go through treatment and then have a healthy baby afterward.

If you want to get pregnant after breast cancer treatment, it's important to talk to your doctor about your fertility options before you start treatment:

  • How serious is your diagnosis? What is your prognosis? Do you feel encouraged to become a parent in the future? Or does your prognosis make you not want to take added risks?
  • How safe is it for you to become pregnant? Talk to your doctor about the safety of pregnancy as it relates to the type of cancer with which you were diagnosed. There isn't definitive evidence that pregnancy affects the prognosis of women diagnosed with breast cancer. But every situation is unique and needs to be evaluated.

If your doctor is confident that pregnancy would be relatively safe for you, ask your doctor and a fertility expert about options for preserving your fertility. Do this before you start treatment. You'll probably want to ask these questions:

  • Does freezing embryos make sense for me?
  • Can I freeze and store eggs now in case I can't produce eggs later?
  • Is ovarian stimulation (with in vitro fertilization) the only realistic option for getting enough eggs?
  • Is there another type of fertility treatment that might be less risky for me?
  • Should some of my ovarian tissue be frozen instead of, or in addition to, my eggs or embryos?
  • Should I consider taking drugs to suppress ovarian function during chemotherapy?
  • What are the demands and costs involved -- medically, financially, and time-wise -- with each approach?
  • Can I postpone treatment? Would it be safe for me to postpone treatment for 6 weeks to allow time for ovulation stimulation and in vitro fertilization?
  • Are fertility drugs safe for me? Are the hormones that will be used to stimulate ovulation safe for me or are the estrogen levels risky?
  • What's my level of commitment? If you're a woman in a committed relationship with a man, you need to be sure both you and your partner are equally committed to having children. If you're single or a woman in a committed relationship with a woman, you, or you and your partner, have to consider whether you're willing to pursue sperm donation.
  • Can I afford fertility procedures? Find out if your health insurance covers fertility procedures and think about what you'll do if the procedures aren't completely covered.

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