The Impact of Cancer on Fertility and Pregnancy
For many women, a diagnosis of cancer means putting their life on hold while they undergo treatment for their disease. This might mean postponing a college education, a wedding, a vacation, a new job, or a major purchase such as a home.
But if a woman is pregnant, or wants to be, how does that fit with her cancer treatment?
Dr. Dené Wrenn, MD, practices gynecologic oncology with OHC. She recommends, “If it is at all possible, women should avoid pregnancy during cancer treatment. Doing so can prevent pregnancy complications.”
She also suggests that any woman of child-bearing age who has been diagnosed with cancer should first see a Reproductive Endocrinologist as soon as possible to discuss fertility-preservation options.
The impact of cancer on fertility and pregnancy is dependent on the type of cancer and how it is handled. Treatment may include surgery, chemotherapy, and/or radiation. All of these methods can have an impact on a current pregnancy or future fertility.
Each chemotherapeutic drug has a different level of toxicity to fertility or a pregnancy. Not all impact the ovaries or the eggs, but those that do can cause abnormalities in the child.
If a woman is already pregnant and needs to undergo chemotherapy, depending on the drug used, it could lead to severe developmental abnormalities for the child. Depending on the type of cancer and which trimester they are in, some mothers will choose to give birth first, before they undergo chemo. The patient’s oncologist will discuss all the options with her before treatment begins.
Radiation therapy can also damage the ovaries. If it is necessary for a woman to undergo radiation to the pelvis then a procedure can be performed to move the ovaries out of the radiation field. This procedure, called ovarian transposition, has a 50 percent success rate in preserving fertility.
For some patients, though, ovary damage can be temporary. While there might be a short period of time when the ovaries don’t produce eggs, function can eventually return for some.
For patients who are concerned that their long-term fertility might be impacted, there are other options to consider, says Dr. Wrenn.
“The first is freezing embryos created outside of the womb and implanting them after the cancer treatment has ended. This procedure works very well and actually has a similar success rate to that of a healthy couple trying to get pregnant.”
In addition to egg freezing, egg donation, embryo donation, surrogates, and traditional adoption are options that female cancer patients have open to them if they wish to have children.
A cancer diagnosis can be a serious, scary event to face. For some women, it might mean postponing pregnancy. “But there is hope,” Dr. Wrenn says, “With adoption and fertility-preserving options, women can look forward to a healthy family life with children after their cancer treatment is over.