15 October 2019

Planning pregnancy after breast cancer treatment

By the Editorial Comitee IVI Blog

A diagnosis of breast cancer brings with it a whole raft of questions and unknowns for patients and their families. However, improved options for treatment and recovery also bring with them the chance to plan for a future relatively unaffected by the illness and its treatment. Breast cancer most often affects older, post-menopausal women, but for those still in their childbearing years, a common concern is whether or not they can plan pregnancy after breast cancer treatment.

The chances of getting pregnant after breast cancer depend on a lot of variables, including the time available to take action between receiving the diagnosis and the start of treatment.

How does breast cancer treatment affect fertility?

The effect of different types of treatment on future fertility depends on a number of factors, including the severity of cancer and the stage at which it was diagnosed, what type of treatment the patient has undergone and the age of the woman being treated. It is therefore impossible to offer any definitive conclusion which would apply to all patients. As a general guide, the different types of treatment and their possible impact are:

  • Chemotherapy:  The main effect of chemotherapy is on the quantity and quality of oocytes. Its impact depends on the type and dose of the chemotherapeutic agent and the age of the patient. Some drugs may cause a direct effect on heart cells. However, this effect is well known by your oncologist and specific test to measure heart function may be indicated before attempting pregnancy.
  • Hormone Therapy: Breast cancer hormone therapy can affect fertility because they completely stop ovulation, effectively putting the patient into temporary menopause. One of the most common, tamoxifen, is also known to cause birth defects. Women in this therapy are therefore strongly advised to use effective contraception.

How long do you need to wait before trying for a baby?

It depends on de recommendation of the oncologist.  There many things that may affect their decision but most of them are related to the risk of recurrence and the time free of disease.   Many chemotherapy drugs have specific time after which patients may attempt pregnancy.

Some patients are treated with hormone therapy that usually lasts for five to ten years and so some people choose to take a break if they want to become pregnant and start again after the birth.

What are the risks of getting pregnant after breast cancer?

Although some breast cancers are hereditary, most cases are linked to somatic mutations acquired during a person’s lifetime rather than genetic factors. Researchers have not found any evidence of a higher risk of birth defects or long-term health issues in the children of women who have had breast cancer.

You could experience difficulties with breastfeeding if you have had surgery or radiation treatment. Structural changes in the affected breast and reduced milk production can cause problems, but many women are able to breastfeed nonetheless. However, if you are on continued medication such as hormone therapy, it is important to take medical advice before trying to breastfeed as some drugs can enter the breast milk and could affect the baby.

Planning for pregnancy after breast cancer treatment: what steps can you take?

Anyone who wants to become pregnant after treatment for cancer should be sure to speak to their health care advisors about the likelihood of infertility before treatment starts, and consider the options for fertility preservation. It could be wise to consider this even if you are not certain at this stage whether or not you want to have children. At least if you do, you are likely to still have a choice after treatment is completed.

  • Vitrification of oocytesThe vitrification of oocytes follows the IVF pattern where mature eggs are obtained following ovarian stimulation. They are then cryopreserved to be used at a later date, with the same chances of success as when they were vitrified. This is the best option when there is time for the ovarian stimulation and maturation of the eggs to be completed. You can see how the process works in our IVI video about the vitrification of oocytes.

The assisted treatments for cancer patients’ preservation of fertility cannot guarantee pregnancy, but at least allow patients to try.

If you would like to know more about the issues around getting pregnant after breast cancer and explore the options for preservation of fertility, we would encourage you to browse our website. It is always up to date with the most recent facts and figures and news about the latest developments and techniques. Or get in touch directly through our online contact form.

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