Fertility and breast cancer treatment

A diagnosis of early breast cancer for younger women can be overwhelming. You may not even be thinking about having children yet, or you may want another child in future. But some breast cancer treatments, especially chemotherapy, can affect your fertility.

There are ways to preserve fertility, to give you a better chance of becoming pregnant after breast cancer treatment.

A fertility specialist and your breast cancer specialist can explain:

• which fertility-preserving treatments are available
• which may be best for your needs and your planned treatment.

Options to preserve fertility

A fertility specialist can help you make the best choice for your situation.

IVF (In Vitro Fertilisation)

IVF involves removing eggs from a woman’s ovary, then fertilising them with sperm. This is done in a laboratory. The fertilised eggs (‘embryos’) can be frozen and stored to use later, after treatment.

The IVF process is complicated and may take several weeks. This can be a problem if you need to start breast cancer treatment as soon as possible. 

Egg freezing

Hormones are used to encourage the ovaries to produce eggs. These are frozen (‘cryopreservation’) and stored until you need them.

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

If you need cancer treatment that affects your fertility, you may be able to access government support. The Assisted Reproductive Technology (ART) Program supports people with cancer and who face extra costs to preserve their fertility. It provides funding to help cover the costs of freezing eggs, sperm and embryos for up to 10 years.

Ovarian tissue freezing

A small piece of ovarian tissue can be removed and frozen before a patient starts chemotherapy. When treatment is complete, the tissue is attached (‘grafted’) back onto the ovary. The hope is that the ovary may start to work again some months later.

Medications

Some medications can protect the ovaries during chemotherapy. Medication such as goserelin (Zoladex) can reduce the possibility of permanent ovarian failure. Goserelin is given as an injection in your stomach every 4 weeks.

This option is only suitable if your breast cancer is hormone receptor positive (HR+).

You can also ask your medical oncologist about having a chemotherapy combination that’s less likely to damage your ovaries.

Donor egg or donor embryo

Using a donor egg or embryo is a common option for women who have no ovarian function. Some people choose surrogacy for a donor embryo. These options can be emotionally and practically complex.

What you may need to consider

•  Breast cancer treatments and the effects of treatment are different for each person. A breast cancer specialist working with a fertility specialist can discuss your best options.
• Different states and territories have different laws for fertility treatments. For example, both partners may need to give consent for treatments such as IVF.
• Not all treatments are available at all fertility clinics
• Fertility treatment can be expensive, so always ask about the cost up front. Check whether Medicare or private health insurance reimbursements are available.
• The area of breast cancer and fertility is rapidly changing, with many ‘unknowns’. Always speak to your medical oncologist or fertility specialist if you have questions. 

Help to make a decision

Fertility-related choices is a guide for younger women with early breast cancer.

It may be helpful if you are of reproductive age (no menopausal symptoms) and may start a family or have more children in future.

It has information on:

• the ways breast cancer treatment may affect fertility
• the options to protect fertility, and their pros and cons

Once you understand the options, use our guide to help decide what is most important to you.

Hear from specialists and patients

Video: Fertility and breast cancer: Know your options

Lee McCarron talks about her breast cancer diagnosis and fertility journey. Breast cancer specialist Dr Rachael Rodgers and Family Therapist Marianne Tome provide their insights.

Podcast: Sofi Leota on breast cancer at 23

Sofi Leota received her breast cancer diagnosis aged 23. She talks about the denial, the disbelief, fertility, and other challenges of being diagnosed at a young age. 

Podcast: Sally Obermeder’s breast cancer journey

TV personality and business owner Sally Obermeder was 40 weeks pregnant with her first child when she was diagnosed with triple negative Stage 3 breast cancer. One week after her daughter was born, she began chemotherapy. She shares her experience from diagnosis to treatment and the decision to use a surrogate for her second child.