Five Questions to Ask About Your Fertility After a Breast Cancer Diagnosis

More than 11,000 women under 40 are diagnosed with breast cancer each year in the United States. But when a young woman receives a breast cancer diagnosis, one of the last things she may be thinking of is her future ability to have children.

But preserving future fertility is an important consideration when making treatment decisions and consulting with physicians.Thus, here are five questions women who receive a diagnosis of breast cancer should ask about their fertility before they embark on cancer treatments.

1. Will My Cancer Treatment Affect My Fertility?

Breast cancer patients treated with surgery and localized radiation may not be at risk for infertility, but those treated with chemotherapy are. It also depends on the woman’s age, the type of chemotherapy and the dosage. Another thing to consider is how long your treatment may last and whether it will delay your childbearing years long enough to pose a risk to your fertility.

2. Who Do I Talk to about Fertility Preservation?

If you have been diagnosed with breast cancer, talk to your oncologist and tell him or her you want to take steps to preserve your fertility. You will need a referral to a reproductive endocrinologist (fertility doctor).

3. What Techniques Are Available to Preserve My Fertility?

There are various options for fertility preservation. If you are a woman who is married or has a partner, you may choose to freeze embryos (embryo cryopreservation). If you are single, you may want to freeze your eggs (oocyte cryopreservation) or use donor sperm to freeze embryos. Both of these techniques require daily injections of synthetic hormones to stimulate your ovaries in order to collect multiple eggs during a menstrual cycle, as well as an outpatient surgical procedure to retrieve the eggs. Other, more experimental therapies include freezing ovarian tissue (ovarian cryopreservation) by surgically removing it, freezing and reimplanting later, as well as ovarian suppression before cancer therapy, in which hormonal therapies are used to suppress ovarian function and protect eggs during cancer treatment.

4. Are Fertility Preservation Methods Successful? Embryo freezing is the most successful technique; however a newer process called vitrification has improved egg freezing dramatically. There are now more than 1,000 “frozen egg babies” born worldwide. Ovarian tissue freezing has produced approximately 15 children. The success rates of ovarian suppression treatments are unknown because there are no randomized trials that demonstrate its effectiveness.

5. How Do I Pay for Fertility Preservation? Fertility preservation techniques such as ovarian tissue preservation, egg freezing or embryo freezing can cost between $12,000 and $20,000 and will probably not be covered by insurance companies. Still, fertility preservation advocates recommend that cancer patients have their fertility doctors code and submit their treatment as cancer treatment. Ovarian suppression methods are less expensive and may be covered by insurance if they are administered in the oncologist’s office. There are also organizations that can help patients with discounts and/or financial support for fertility preservation.

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