When Kome got married, the next thing on her mind was having a baby, but that wasn’t what happened. Instead, she was diagnosed with breast cancer- invasive ductal carcinoma, on one of her visits to the doctor.
It was a shocking diagnosis that destabilised both herself and her new husband. They moved from their regular doctor to an Oncologist, who wanted to aggressively start treatment; chemotherapy, radiation, and surgery were scheduled for her.
But before then, she suggested they see a fertility specialist, especially as they were a young couple and would want to try for a baby sometime in the future.
Kome went to see the doctor, who mentioned that cancer treatment would affect her fertility in the future and suggested she harvest her eggs or have them fertilized with her husband’s sperm, so they could have embryos to freeze until she was ready to have a child. It wasn’t her preferred route, but life had thrown lemons at her, so she was surely going to make lemonade out them.
Usually, fertility after chemotherapy depends on two things; age and the types and doses of chemotherapy medicines. As every woman ages, her ovaries produce fewer fertile eggs. And as menopause sets in; the ovaries stop making fertile eggs all together.
Thus, women who are treated for cancer while younger than age 30 have the best chance of becoming pregnant after chemotherapy. Overall, the younger you are, the more likely it is your ovaries will produce fertile eggs after chemotherapy.
Women in their 50s are a lot more likely to find themselves menopausal, at the end of chemotherapy. And it is the same thing with women who are in their 40s.
Kome was less than 30 at the time of her diagnosis and underwent several months of chemotherapy. When she reflected back on the very difficult year she had, she recalled that the hardest part of her diagnosis was that her treatment could affect her ability to bear children. And who wouldn’t?
Chemotherapy and Women’s Fertility
Chemotherapy stops the ovaries from working for a while, or possibly permanently. Whether the effects of the infertility are temporary or permanent depends partly on the drugs and doses that you have. Some chemotherapy drugs are more likely than others to cause infertility. The key is to be one’s self- advocate.
Permanent infertility is more likely if higher doses of the drugs are administered. For some women, although their periods stop during chemotherapy, they may still be producing eggs and could still get pregnant.
So it is best to continue using reliable contraception even if your periods do stop, as getting pregnant while undergoing chemotherapy could harm the baby.
On a temporary basis, chemotherapy can make your period become irregular or stop during treatment. But it should go back to normal once your treatment is over.
According to my research, this happens in about a third of all women whose periods stop because of chemotherapy. It takes about 6 months to a year for Aunt Flo to go back to normal after your chemotherapy has finished.
It is not as easy for women to preserve their fertility as it is for men but there are ways of doing it, such as embryo freezing, egg freezing and even freezing ovarian tissue.
These techniques are done before the chemotherapy starts. To freeze embryos and eggs, you have drugs to stimulate your ovaries so the doctor can collect eggs. There are 2 possible problems with this. Firstly, it may be more difficult to have this type of treatment with some types of cancer.
Some research is looking into removing ovarian tissue and freezing it before chemotherapy starts. And it has actually proven possible, as a baby was born recently from the frozen ovarian tissue of a young woman, which was frozen when she was a teenager. The idea is that after treatment, the ovarian tissue can be put back. If the ovarian tissue then starts working normally, eggs may be produced and so fertility is preserved. The results of this tests look really promising.
Getting pregnant after treatment
Most doctors will advise women that it is best to wait for 2 years after chemotherapy treatment before becoming pregnant. But this is not because the pregnancy could affect the cancer. They recommend this because, if your cancer is going to come back, it is most likely to recur within the first 2 years after your diagnosis. If the cancer came back, you’d need more treatment. As you might expect, this could be very difficult if you were either pregnant or had a young baby.
Although, there is no evidence that pregnancy increases the risk of breast cancer or melanoma coming back – two of the types of cancer women are often told can be affected by pregnancy hormones.
Fertility options after cancer treatment
There are some other options that women might consider if their fertility has been affected by cancer and treatment. There are lots of complex issues to think about with these methods, and some options may not be as straight forward as they would think and our society is not even fully ready to accept some of these options. But who cares?
Women dealing with the aftermath of breast cancer and chemotherapy may consider:
- Using donor eggs
- Using donated sperm so they can freeze embryos rather than eggs
- Using donated embryos
- Surrogacy (when another woman carries the baby for you)
Those are the choices, but they are not one for everyone. Some moms finally arrive at the decision to use these options and some don’t ever, waiting only for their own babies.
The truth that I have found out is, there are so many paths to motherhood. We just have to find the one that works for us and stick to it.
Ultimately, there is life after breast cancer, after chemotherapy and it is worth living for.
Food for thought!
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