Fertility and breast cancer

As a young person, being diagnosed with breast cancer can be really overwhelming. On top of making decisions about which cancer treatment is right for you, you also need to think about how that treatment may potentially impact your fertility.

You may already be planning a family one day, or you may not have thought about it yet, which is why it’s so important to discuss fertility and family planning with your doctor before your treatment begins so that you understand how your cancer treatment may affect your fertility.

Leaving the discussion about fertility until after breast cancer treatment starts can significantly limit the available options.

Fertility and breast cancer

If preserving your fertility is important to you, there are various options available. Your breast cancer specialist can refer you to a fertility specialist who will explore and discuss with you your options. This will allow you to make an informed decision about what is the best choice for you. It is usually possible to delay treatment for a week or two while you consider your fertility options and undergo fertility treatment if you choose.

Fertility preservation options

There are a number of methods for preserving fertility so that you can have a chance of becoming pregnant after breast cancer treatment.

Some of these options require action before treatment starts so it is important to get specialist fertility advice.

In Vitro Fertilisation (IVF)

IVF uses your eggs with either your partner’s or a donor’s sperm. The fertilised egg can be frozen for use later when you recover.

The process is complicated, and the fact that it may take several weeks can be a problem if you need to start your breast cancer treatment as soon as possible.

Options that involve stimulating the body with oestrogen may not be recommended for people with oestrogen receptor positive breast cancer.

Egg freezing

Egg freezing involves stimulating the ovaries with hormones to produce eggs that are then frozen (this is sometimes called cryopreservation) and stored until required.

This process is also complicated and has the same time delay as IVF, so you will need to discuss with your specialists whether it’s appropriate for you.

There is a government program that supports people who have cancer and who face extra costs to preserve their fertility called the Assisted Reproductive Technology (ART) Storage Funding Program. It provides funding to help cover the costs of freezing eggs, sperm and embryos for up to 10 years. To be eligible you need to have a cancer diagnosis that requires treatment that will affect your fertility.

For more information see ART Storage Funding Program.

Ovarian tissue freezing

Ovarian tissue freezing and auto-grafting of ovarian tissue is a fertility preservation option.

It involves freezing a small piece of ovarian tissue before a person starts their chemotherapy and grafting it back onto the ovary after treatment is complete, in the hope that the ovary may start to function again some months later.

Medication

Medication such as goserelin (Zoladex) may be given during chemotherapy treatment to reduce the chemotherapy’s impact on fertility.

This is only appropriate if your breast cancer is hormone receptor positive.

Donor egg or embryo

Using a donor egg or embryo is a widely practised and successful option for people who have no ovarian function.

Some people choose surrogacy for donor embryo. These options can be emotionally and practically complex.

The costs and availability of fertility preservation treatments and the laws relating to these, vary between states and territories within Australia. These factors will need to be taken into consideration when choosing a fertility preservation method.

It is important to remember that breast cancer treatments and the effects of treatment are different for each person. A breast cancer specialist working together with a fertility specialist will be able to provide the best options for your particular situation.

Breast Cancer Network Australia has produced a fertility resource to help guide you every step of the way. In the below video, our fertility specialists explain the potential risks to your fertility and step you through the range of fertility preservation options available for you to consider before you start your breast cancer treatment.

Four women share their stories. All at different stages of their life at the time of their diagnosis, Mallory, Katie, Shari and Jane are still so grateful for the conversations they had and the decisions they made following their breast cancer diagnosis.

Things you can do now

Watch BCNA’s video Fertility and breast cancer-knowing your options webcast.
Listen to BCNA’s podcast: In conversation with Shananne and Kate: Under 40 and experiencing breast cancer.
Read BCNA’s booklet Fertility-related choices: A decision aid for younger women.
Read the Cancer Australia Statement Influencing best practice in breast cancer, which includes the importance of discussing fertility with premenopausal women before starting breast cancer treatment.
Visit My Journey, BCNA’s online tool for information tailored to your diagnosis. My Journey has a Symptom Tracking tool that you can use to help you record your pain, what works for you and what doesn’t.
Join our Online Network if you think that talking to others online and sharing experiences will help.
Contact BCNA’s Helpline on 1800 500 258 between 9.00 am and 5.00 pm AEST Monday to Friday, for information about the services and support that may be available for you and your family.