Breast Cancer and Infertility Treatment  

Multiple factors can affect your fertility. Breast cancer and cancer treatment can lead to infertility for various reasons. Dominion Fertility is here to assist you in preserving your fertility so you can focus on your cancer treatments while having the peace of mind that creating a family is still attainable in the future. 

Breast Cancer and its Impact on Fertility

Breast cancer treatments may cause infertility. Chemotherapy for breast cancer can cause immediate or delayed infertility. Chemotherapy kills cells in the body that are dividing too quickly. Oocytes, which are pregnancy cells of the ovaries, divide rapidly and are often affected by chemotherapy. The loss of essential hormones can have a negative impact on fertility. 

Many factors determine if someone will be fertile after chemotherapy treatment, including:

• Stage in life (before or after puberty or after menopause)
• Menstrual history
• Hormone levels
• Type of cancer and treatment
• Treatment doses

 Due to this, it is tough to predict if someone with breast cancer can get pregnant naturally after undergoing chemotherapy. 

Hormone therapy, commonly used to treat breast cancer, may lead to infertility as a side effect. While these drugs may not affect the ability to get pregnant, they can cause congenital disabilities. Other hormone therapies may block hormones, which can cause early menopause. 

Options for Preserving Fertility During Breast Cancer Treatment

At Dominion Fertility, we expedite your fertility treatments with our medical team to ensure you do not have to delay treatment for your cancer. Our fertility specialists can explore fertility preservation options with you. 

Options for fertility preservation include: 

• Freezing embryos created with IVF ‍
• Freezing unfertilized eggs

Embryos created during an IVF cycle can be cryopreserved on days five to six of development at the blastocyst stage. If an individual or couple desires preimplantation genetic testing (PGT-A), embryos undergo PGT-A before being frozen. Your fertility specialist will select one embryo for transfer at a later date. If you have multiple embryos of good quality, the rest of the embryos will stay cryopreserved in liquid nitrogen. Embryos can remain frozen for many years. 

Your fertility specialist can also freeze eggs without fertilizing them through IVF. Our fertility experts will evaluate your ovarian reserve using a sonogram and blood test to assess the quality of your eggs. After testing, you will take fertility stimulation hormones for about ten days. Our fertility specialists perform the egg retrieval process in our office under anesthesia, and our lab technicians expertly handle the cryopreservation of your eggs until you are ready to use them. There is currently no limit on how long eggs can be stored. 

Challenges and Considerations in Combining Breast Cancer Treatment with Fertility Preservation

Since breast cancer is becoming more common in individuals of reproductive age, the American Society of Clinical Oncology (ASCO) recommends timely referrals of patients to fertility clinics before the initiation of cancer treatment. Anyone diagnosed with breast cancer who is of reproductive age should be counseled on their fertility options, as fertility concerns may significantly impact their treatment decisions. 

Controlled ovarian stimulation in cancer patients should consider two safety issues: delay of cancer treatment and ovarian hyperstimulation syndrome (OHSS). When determining fertility preservation options, it could take up to two weeks to complete preservation and can cause a negative impact of ovarian stimulation in hormone-responsive tumors. Evidence has shown better outcomes when treatment for breast cancer is started earlier. Dominion Fertility expedites fertility preservation in all cancer patients. 

Individuals with a high ovarian reserve should be aware of the risk of ovarian hyperstimulation syndrome (OHSS), a rare complication of controlled ovarian stimulation. OHSS results in enlarged and tender ovaries with minimal free fluid in the abdominal cavity. If severe, it can cause nausea, vomiting, shortness of breath, and dehydration and require management in the hospital. If this occurs, it could delay starting cancer treatment. At Dominion Fertility we use medication protocols that minimize the risk of OHSS.  

Some breast cancers are sensitive to estrogen, so some individuals may be concerned about performing ovulation stimulation on someone with cancer or that their breast cancer may come back during pregnancy due to the increased hormone levels from pregnancy. However, studies have shown that pregnancy does not increase the risk of cancer returning after successful treatment. 

Post-Treatment Fertility Options

The timing of when to try to get pregnant after having breast cancer may depend on the type of breast cancer the individual has and is not always clear. Some providers recommend that individuals with hormone receptor-positive breast cancer taking hormone therapy wait five to ten years after the initial treatment. If an individual or couple desires pregnancy during this time, it is recommended to take hormone therapy for at least two years before stopping it and then waiting a few months before trying to conceive.

Most breast cancer survivors can try to become pregnant after two years as this allows enough time to find any early return of the cancer. 

If you choose to have your eggs or embryos frozen for future use, we are here to help you when you are ready to start growing your family. 

Support and Counseling for Individuals Facing Breast Cancer and Infertility

Coping with breast cancer and infertility can be a lot. Dominion Fertility has resources to help you as you embark on this journey. We offer monthly provider-led support groups hosted by one of our mental health providers. These virtual groups address various aspects of the infertility journey, from managing feelings of isolation during fertility treatments to coping with grief and developing resilience. 

We also offer private online patient groups for anyone struggling with infertility, trying to conceive through infertility procedures, or needing more support and information. One of our private support groups is our Egg Freezing Support Group for anyone interested in freezing their eggs or who has already frozen them and wants to connect with others. 

Here to Help

Being diagnosed with breast cancer and choosing cancer treatments can be overwhelming. Dominion Fertility can help you decide on fertility preservation options so you can choose to start or grow your family after you’ve completed cancer treatments. Schedule a consult with one of our fertility specialists to learn more about your options. 

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