Options If You Can’t Get Pregnant After Breast Cancer Treatment
It’s possible to have a baby after completing breast cancer treatment. But some treatments can make it more difficult to get pregnant. For example, chemotherapy might damage the ovaries, which can sometimes cause immediate or delayed infertility.
The best time to talk to your doctor about your fertility options is before you begin breast cancer treatment. You may also want to meet with a fertility specialist.
Fertility-preservation techniques
There are various ways of preserving fertility during breast cancer treatment. If you know you want to get pregnant one day, your doctor and fertility specialist can help you choose an option that makes sense for you.
The process of freezing embryos or eggs, called cryopreservation, helps to preserve fertility and is an option if you want a baby and are about to start breast cancer treatment. Collecting eggs to freeze embryos can take from several days to a few weeks because it depends on the menstrual cycle. If you are freezing eggs, where you are on your menstrual cycle is not as important.
Learn more about freezing eggs or embryos.
In vitro fertilization (IVF) is the process of fertilizing harvested eggs with sperm in a laboratory dish. In vitro means outside the body. When the fertilized eggs divide, they become embryos and are ready to be either implanted or frozen.
After completing breast cancer treatment, you can have the embryos implanted in your uterus, even if your periods have not returned. Most clinics try not to transfer more than one embryo at a time so — if pregnancy is successful — it results in one baby or twins at most. IVF’s success rate varies based on factors such as how old you are when the embryo is frozen. IVF does not guarantee a successful pregnancy.
Egg donation is another fertility-preservation option, especially when it’s not possible to extract eggs before starting breast cancer treatment and the ovaries don’t produce ripe eggs anymore.
Your doctor and fertility specialist can recommend a trusted fertility center or clinic, egg donor agency, or donor registry. You may also want to take a look at the Society for Assisted Reproductive Technology to get an idea of what to expect.
Ask your doctor or fertility specialist to discuss each fertility option’s risks and chances of success.
What if you can’t get pregnant?
No fertility treatment works 100% of the time. If fertility treatments have not worked for you (or are not a possibility), there are still family planning options to consider after breast cancer:
traditional surrogacy
gestational surrogacy
adoption
A traditional surrogate is someone who is both the egg donor and the person who carries the fertilized egg to term and delivers a baby for someone who can’t get pregnant. There is a genetic link between the traditional surrogate and the baby.
A gestational surrogate also carries a fertilized egg to term and delivers a baby for someone who can’t get pregnant. But a gestational surrogate is not the egg donor and has an embryo implanted in the uterus using in vitro fertilization (IVF). There is no genetic link between the gestational surrogate and the baby.
If pregnancy after breast cancer treatment is not possible, using a traditional surrogate or gestational surrogate might be a family-planning option to consider.
There are several ways gestational surrogacy can work:
The gestational surrogate carries a fertilized donor egg to term.
The gestational surrogate is implanted with one or two of your frozen embryos and carries to term.
The gestational surrogate carries one of your own fertilized frozen eggs to term.
Your doctor or fertility specialist can recommend a gestational surrogacy agency or program. Some gestational surrogacy programs are independent, and others are affiliated with major medical centers. Some people prefer to find a gestational surrogate by asking family and friends.
It’s important to know that gestational surrogacy laws vary widely from state to state. Experts recommend using a trusted in vitro fertilization center for its legal protection and reliability. But if you still want to find a gestational surrogate on your own, it’s essential to:
know what the regulations are in your home state
understand that you and the gestational surrogate each need an attorney to draw up a contract and represent your interests
It’s also important to know that gestational surrogacy can cost thousands of dollars to cover the following:
compensation for the gestational surrogate
medical costs and other expenses for the gestational surrogate
attorney fees
psychological testing fees
Your own health insurance plan is unlikely to cover medical costs for the gestational surrogate. And it makes sense to confirm in writing whether the gestational surrogate’s health insurance plan covers the pregnancy before moving too far ahead with the process. You may need to find a health plan that covers surrogate pregnancy, but these plans can be expensive.
If fertility treatments or surrogacy aren’t right for you, then you may want to consider adoption. It’s helpful to talk to an experienced adoption counselor who can help guide you through the process.
In the United States, there are three main ways to adopt:
private domestic adoption
international adoption
foster adoption
Laws for domestic adoption, international adoption, foster adoption, and even post-adoption legal matters vary by state. It makes sense to familiarize yourself with your home state’s policies before beginning any adoption process. A good place to start is Adoptive Families, which lets you view adoption laws by state.
At some point in the adoption process, it’s necessary for your doctor to fill in a medical form that is very likely to ask if you’ve had a life-threatening illness such as cancer. It’s important to answer truthfully to avoid ending your chances of adopting.
Many of the forms are very general and brief, so you may want to ask your doctor to write a detailed letter. A supportive letter from your doctor should explain your diagnosis, treatment, and prognosis. Ideally, your doctor should write the letter in plain, easy-to-understand language, avoiding medical jargon and abbreviations.
Your doctor should also use the terms “cancer-free ” and “normal life expectancy” if these apply to you. Most adoption agencies look for these terms. It may make sense for you to write a first draft of the letter and take it to your doctor for review. Your doctor can make edits and give you an official signed letter.
Domestic adoption can cost thousands of dollars. International adoption is even more expensive because of international fees and travel costs. Foster adoption is much less expensive and may not even cost anything at all, depending on the situation.
— Last updated on April 23, 2024 at 2:09 PM