Pregnancy after cancer: What are the options before and after treatment?

Obehi Asemota, MD

Obehi Asemota, MD, Assistant Professor, Department of Obstetrics and Gynecology

The ability to have children and build a family is important to many cancer survivors. It is also reassuring to cancer survivors that scientific studies have shown that pregnancy after cancer is safe.

In 2015, an estimated 810,170 women in the United States were diagnosed with some form of cancer. Approximately 8%, or 60,000, of these women were under the age of 40, with breast cancer being the leading cancer for women in the US. Advances in treatment allow these young cancer patients to survive their disease and live a normal life.  Unfortunately, many therapies that improve survival for cancer patients have side effects including loss of fertility and early menopause.

To preserve fertility, cancer patients can turn to Oncofertility, an interdisciplinary field that bridges oncology (the study of cancer) and reproductive women’s health to expand and provide options for preserving fertility in patients facing fertility-threatening therapies.

Some of these options can be used before cancer treatment:

  • In vitro fertilization with frozen embryo banking: In vitro fertilization with frozen embryo banking is the most established form of fertility preservation and is an excellent option for women who have a male partner or are interested in using donor sperm.
  • Egg freezing and banking: Egg freezing and banking is another option to preserve fertility prior to cancer treatment. Due to advances in field of reproductive medicine, egg freezing is no longer experimental and for women without partners, egg freezing and banking is a viable option.  Women with cancer can have an opportunity to preserve their fertility which would give them the chance to have a family after treatment of cancer.
  • Fertility sparing surgery: For patients who will receive abdominal or pelvic irradiation, it is possible to move the ovaries surgically out of the radiation field. In addition, for patients with early stage gynecologic cancers, it is often possible to conserve reproductive organs at cancer surgery and successfully treat the cancer. One such surgery is radical vaginal trachelectomy performed by Ernst Lengyel, MD, PhD, the Arthur L. and Lee G. Herbst Professor of Obstetrics/Gynecology and Chairman of Obstetrics and Gynecology.
  • Additional options: Preimplantation genetic diagnosis, ovarian suppression with hormonal therapy, ovarian shielding from radiation, psychological support and financial counseling are among other options that are available for women with cancer
  • Experimental treatments: Although pregnancies have been reported with ovarian tissue freezing, ovarian tissue freezing and transplantation is considered experimental

Other options can be utilized after cancer treatment:

  • Fertility treatment with In Vitro Fertilization (IVF): For women who are subfertile after cancer therapy, traditional assisted reproductive technologies such as IVF may be appropriate to help some cancer survivors achieve pregnancy.
  • Third party reproduction–Egg donation: For cancer survivors who become menopausal with cancer treatment, egg donation is a highly effective option for becoming pregnant.
  • Third party reproduction–Gestational surrogacy: A gestational surrogate is a woman who will carry a pregnancy for intended parents.  Because some women are unable to carry a pregnancy after cancer therapy, having a gestational surrogate carry their pregnancy may be an option for these cancer survivors.

“Having cancer can be a devastating and overwhelming diagnosis,” said Helen Kim, MD, Chief of the Section of Reproductive Endocrinology and Infertility. “Our goal at the oncofertility program is to provide timely and compassionate support, to cancer patients facing fertility-threatening treatments.”

To schedule an onco-fertility consultation, please call 773-702-6642.

About Obehi Asemota, MD (1 Article)
Obehi Asemota, MD, is an Assistant Professor in the Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology and Infertility at the University of Chicago Medicine.
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