Fertility for LGBTIQ+ people with breast cancer

Breast cancer and its treatment may reduce your choices about if, when or how you experience pregnancy. It can affect your ability to conceive or maintain a pregnancy. LGBTIQ+ people have the same rights as other people to know how breast cancer may affect their fertility, to discuss fertility options and to access fertility preservation.

Impact of breast cancer and cancer treatment on fertility

The effects of breast cancer treatment on fertility can be temporary or permanent. Chemotherapy and radiotherapy may cause damage to reproductive organs or reduce levels of hormones produced in the gonads. For some people, breast cancer treatment may lead to early menopause. For more information read Early menopause and breast cancer treatment

Cancer and cancer treatment may also change your feelings about sex, due to low libido or changed feelings about your body. You may also experience physical problems or discomfort, such as pain, tiredness, or genital dryness. These concerns can affect your ability to conceive. If you choose to conceive through artificial reproductive technology (such as sperm donation) these sexual changes may not affect your fertility. See Sexuality and intimacy for LGBTIQ+ people with breast cancer.

Knowing your fertility options

It is important to be aware of the possible impact of cancer treatments on your fertility and your options for fertility preservation. Sometimes treating teams do not initiate discussions around fertility with LGBTIQ+ people, or they may make inaccurate assumptions about if, when and how you wish to be a parent. If you think you would like to have a biological child in the future, it is important to talk through your options with your treating team before you start cancer treatment.

If you have a partner, or children, you may want to include them in discussions with your treating team about fertility concerns and preservation options. This may mean disclosing your sexual orientation, gender, or variations in sex characteristics to your treating team.

Communicating with your partner about whether you would like to have a (or another) child in the future before you start any treatment is important. You may also like to discuss with your treating team the different ways you could start a family. For example, if your partner has a uterus, you could discuss reciprocal IVF treatment or egg sharing , donor eggs and options around who would carry a pregnancy. You may like to explore adoption, fostering or kinship care.

If you are a trans person, you may have additional questions or concerns about fertility. For general information you can visit TransHub, and for information specific to your situation, speak to your treating team.

Acknowledgements

These materials were developed from the Out with Cancer Study, conducted at Western Sydney University, and funded by the Australian Research Council. Thanks are offered to the Out with Cancer study committee members with lived experience of cancer, BCNA LGBTIQ+ consumer representatives, ACON and LGBTIQ+ Health Australia who contributed their time and expertise.

BCNA's LGBTIQ+ project was undertaken with support from Cancer Australia through their Supporting Women in Rural Areas Diagnosed with Breast Cancer program

Resources

Cancer Council - LGBTIQ+ People and Cancer. The Cancer Council NSW has detailed  information on its website including a downloadable book that will help you understand how cancer and its treatment may affect LGBTQI+ people – lesbian, gay, bisexual, transgender, queer, and other diverse sexualities and genders, as well as people with intersex variations.

Cancer Council - Fertility and Cancer. Cancer and its treatment may affect a person’s ability to conceive a child or maintain a pregnancy (fertility). This booklet developed by Cancer Council help you understand more about the impact of cancer treatment on fertility.

Fertility-related choices: A decision aid for younger women with early breast cancer. This booklet is for young women who have been recently diagnosed with early breast cancer. It includes information about the ways breast cancer treatment may affect fertility, the fertility options that can be considered and guidance with decision-making through a workbook-based process. This booklet may be helpful if you are still of reproductive age (having regular periods and no menopausal symptoms), and are thinking of starting a family or having more children in the future. This booklet is currently available as download only and is unable to be ordered as a hard copy.

Rainbow Fertility Doctors. This website can help you to find LGBTIQ+ friendly fertility specialists in your area.

Webcast: Fertility and breast cancer - knowing your options.
In this webcast, presented by BCNA, you will hear from Dr Rachael Rodgers, Gynaecologist and Fertility Specialist and Marianne Tome, Family Therapist. The webcast also features Lee McCarron, BCNA Consumer Representative and explores breast cancer treatments, such as chemotherapy and hormone-blocking therapy, can impact the fertility of premenopausal/young women diagnosed with breast cancer.

AccessAustralia. AccessAustralia is a consumer controlled,  not-for-profit charity, committed to providing whole of life support for women and men who experience difficulties conceiving and their families. Their website can help find a fertility counsellor, IVF clinic and also provides information