Fertility, Pregnancy, Adoption

If you're thinking about having a baby, and you're also dealing with breast cancer, you face all sorts of difficult questions. What are your options for receiving treatment AND preserving fertility? How do you decide what's most important to you? Is there anything you should do urgently? What can wait till later?

Perhaps you've just been diagnosed with breast cancer and are about to start chemotherapy. Your doctor says you could go through early (premature) menopause and become infertile from the chemo.

That news makes you feel even worse. You may already feel overwhelmed by your diagnosis and efforts to find the right doctors and best treatments. You may be unsure about what the cancer will mean to your future. Now, you must also worry about whether cancer and its treatment will alter your chance of having a child.

Or perhaps you're past the early shock and finished with your cancer treatment. Now you have one main thing on your mind: finding out if you're still fertile — if you can make a baby happen before it's too late.

Many women share these concerns. You may want to become pregnant after treatment but are not yet in a committed relationship. You might be married or in a committed relationship, but not quite ready to start a family. Or you may already have one child (or more), and want very much to have another.

Fertility issues affect so many aspects of your life in so many significant ways. This section will help you understand more about what you need to know for YOUR situation.

The experts for Fertility, Pregnancy, Adoption are:

• Kutluk Oktay, M.D., associate professor, Weill Medical College, Cornell University, New York, NY
• Leslie Schover, Ph.D., associate professor of behavioral science, University of Texas M. D. Anderson Cancer Center, Houston, TX
• Marisa C. Weiss, M.D., breast radiation oncologist, Thomas Jefferson University Health System, Philadelphia, PA

These experts are members of the Breastcancer.org Professional Advisory Board, including more than 70 medical experts in breast cancer-related fields.

Background studies for this section include:

• M. Sonmezer and K. Oktay. Fertility preservation in female patients. Human Reproduction Update, 2004, Vol.10, No.3 pp.251-266.
• L. A. Emens and N. E. Davidson. Adjuvant hormonal therapy for premenopausal women with breast cancer. Clinical Cancer Research, January 2003 (suppl.), Vol. 9, 486s-494s.
• M. Friedlander and B. Thewes. Counting the costs of treatment: the reproductive and gynaecological consequences of adjuvant therapy in young women with breast cancer. Internal Medicine Journal, 2003;33:372-379.
• S. E. Minton and P. N. Munster. Chemotherapy-induced amenorrhea and fertility in women undergoing adjuvant treatment for breast cancer. Cancer Control, November/December 2002, Vol. 9, No. 6.
• S. Upponi et al. Pregnancy after breast cancer. European Journal of Cancer, April 2003.
• D. Rosner and J. Yeh. Breast cancer and related pregnancy: suggested management according to stages of the disease and gestational stages Journal of Medicine, 2002, Vol. 33, nos. 1-4, p. 23-62.
• Woo, et al. Breast cancer in pregnancy. Archives of Surgery, January 2003.
• A. J. Keleher et al. Multidisciplinary management of breast cancer concurrent with pregnancy. Journal of the American College of Surgeons, January 2001, p. 54-64.
• Ginsburg et al. In vitro fertilization for cancer patients and survivors. Fertility and Sterility, 2001; 75:705-10.
• D. E. Tourgeman. Ovulation induction is not the same as superovulation: the effect of selective estrogen receptor modulators and aromatase inhibitors. Fertility and Sterility, 2003; 18:90-95
• T. Falcone et at. Ovarian Function preservation in the cancer patient. Fertility and Sterility. 2004; 81(2)243-57, p. 244.

This section was made possible by an unrestricted educational grant from the Stulman Foundation.