Getting Pregnant Problems: Female Fertility and Chemotherapy
For women undergoing chemotherapy who would like to one day get pregnant, one main concern is: can chemotherapy cause infertility? Chemotherapy can impair a woman's chances of getting pregnant; however, in some cases the effects of chemotherapy are short term and a woman is able to conceive following her cancer treatment.
So how exactly does chemotherapy affect female fertility and for how long does it impair a woman's chances of getting pregnant?
Chemotherapy: How Does It Affect Female Fertility?
Chemotherapy does not always affect a woman's chances of getting pregnant; however, this type of cancer treatment can inhibit the proper functioning of the ovaries either on a short term (temporary) or long term (permanent) basis. The effects of chemotherapy on a woman's fertility depend on the type of drugs administered during cancer treatment as well as the dosage of these drugs, with higher dosages resulting in an increased risk of long term female infertility. You should speak to your health care provider regarding your concerns on the effects of chemotherapy on your fertility.
Chemotherapy and Short Term (Temporary) Infertility
Temporary infertility that is caused by chemotherapy results in irregular menstruation or amenorrhea (lack of menstruation) during cancer treatment; however, regular menstruation resumes after treatment ends, typically 6 to 12 months following the end of chemotherapy. This type of short term infertility occurs in one third of all cases.
Younger women are more likely to experience short term infertility as a result of chemotherapy.
In some cases, menstruation ceases during the course of chemotherapy, however the ovaries still produce eggs, resulting in a chance that conception may occur. As such, it is important to use contraception during treatment because chemotherapy drugs can harm the development of a fetus. You should speak to your doctor about female contraception use during chemotherapy.
Chemotherapy and Long Term (Permanent) Infertility
Long term infertility that is a result of chemotherapy is typically linked to certain types of drugs, as well as higher dosages of these drugs being used during the course of chemotherapy. Chemotherapy drugs that are linked to a high risk of infertility include cyclophosphamide (Cytoxan). Drugs with a medium risk of infertility include Platinol (chemical name cisplatin) and Adriamycin (doxorubicin); alternatively, methotrexate 5-fluorouracil and vincristine pose little or no risk of infertility.
In addition, chemotherapy is more likely to cause permanent infertility in older women who are reaching the stage during which menopause generally occurs (on average age 51). Women 35 and older are particularly vulnerable to a cessation of ovarian production, particularly after the age of 40.
In this case, chemotherapy results in the termination of the ovaries' ability to produce eggs, meaning that a woman is unable to conceive. Women may also experience symptoms of early menopause, including reduced libido, mood wings, hot flushes, vaginal dryness and reduced energy levels.
Maintaining Female Fertility During Chemotherapy
Three options that can help you preserve your fertility while undergoing chemotherapy are freezing embryos, eggs or ovarian tissue.
These processes must be conducted prior to chemotherapy and depend on the type of cancer being treated; for example, these fertility saving options are not recommended for women with hormone dependant breast cancer.
Frozen eggs or embryos can be used in the process of in vitro fertilisation (IVF) following chemotherapy, which can increase your chances of getting pregnant after chemotherapy.
Ovarian tissue that is removed and cryogenically frozen can be surgically re-implanted; however, while early trials of this process have been promising, ovarian tissue surgery is relatively new and as such there is a lack of data regarding its rate of success in achieving pregnancy.
Female Fertility After Chemotherapy: Getting Pregnant Following Treatment
Generally, it is recommended to wait two years following the end of chemotherapy treatment in order to try to conceive. This is because the risk of cancer recurring is highest in the two years following treatment.
Therefore, in the case that cancer does return, it can be difficult to receive treatment if you are pregnant or have a young baby.
There is no evidence that pregnancy increases the risk of melanoma or breast cancer, two cancers which pregnancy hormones are believed to affect.
Chemotherapy During Pregnancy
If you are pregnant prior to diagnosis and cancer treatment, you should speak to your doctor regarding your options and fully understand the benefits, risks and complications associated with these options.
In some cases, chemotherapy is delayed until after birth; however, sometimes chemotherapy treatment is administered during the last stages of pregnancy, depending on the type of cancer, the extent of the disease, as well as the type of drugs used.
If it is recommended that you undergo chemotherapy as soon as possible, termination of an early pregnancy may be advised. If pregnancy is in its later stages and immediate treatment is recommended, an early birth may be advised.
Chat with other women under going chemotherapy and get advice on how to preserve your fertility.
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