Fertility Preservation and Other Reproductive Options
Is pregnancy one of your goals, sometime in the future? If so, it’s important to have a conversation with your doctor right away. Together, you can decide whether it makes sense to talk with a fertility specialist now or explore your options later. Some fertility preservation procedures need to happen quickly—before treatment begins—so the sooner you ask, the more choices you may have.
Fertility Preservation Considerations
Fertility preservation may improve your chances of a future pregnancy, but like any medical treatment, it comes with pros and cons. Here are a few things to keep in mind:
Cost
Your expenses may not be covered by insurance. Fertility treatment providers can help you navigate costs, insurance questions, and available financial assistance.
Availability
Certain options are only available in specific locations or through select providers.
Side Effects
Some treatments come with temporary or long-term side effects you’ll want to understand up front.
Below are some of the available fertility preservation options that may help protect your fertility before, during, or after breast cancer treatment.
Your doctor and a fertility specialist can help you understand what’s possible and create a plan that aligns with your treatment and your goals.
Cryopreservation
Cryopreservation (cry-oh-prez-er-VAY-shun) is a process that involves freezing and storing eggs, embryos, or other reproductive tissue at extremely low temperatures for future use. It’s one of the most common and effective ways to preserve fertility before breast cancer treatment begins.
Research shows that banking eggs or embryos before treatment is safe and does not increase the risk of cancer recurrence, whether in the breast or elsewhere in the body. That means you can move forward with treatment and still keep the door open for a potential future pregnancy.
There are a few different types of cryopreservation.
Here’s how they work:
Freezing a Fertilized Egg (also called embryo freezing).
Freezing an Unfertilized Egg
Freezing Ovarian Tissue
Genetic Considerations
If you’re thinking about pregnancy, your family history may also factor into your decision. Some people carry inherited gene mutations—like BRCA1 or BRCA2—that can be passed to their children. If this is a concern for you, one option is preimplantation genetic diagnosis (PGD).
PGD would involve fertility preservation, where eggs are collected and fertilized to create embryos. These embryos are tested to see which ones carry the gene mutation and which do not. If you choose, only embryos without the mutation can be implanted.
Remember, choosing PGD is a deeply personal decision. It may help to talk with your oncologist, fertility specialist, OB/GYN, mental health provider, and trusted loved ones for support and guidance.
Medical Ovarian Suppression
Medical ovarian suppression uses hormone shots, like leuprolide (Lupron) or goserelin (Zoladex), during cancer treatment to temporarily shut down your ovaries. This may help protect them from damage caused by chemotherapy. These hormone shots can come with their own side effects, so talk with your doctor about what to expect and whether this option is right for your situation.
Beyond Fertility Preservation: Donor Options
If preserving fertility isn’t possible, there are still ways to build a family. Reproductive options using donor eggs, sperm, or embryos can help. For many young adults with breast cancer who are unable to become pregnant, donor eggs or donor embryos are common paths. Here’s how they work:
Donor Eggs or Oocytes (oh-oh-sites)
- If infertile after treatment, you may be able to use donated eggs
- Donated eggs are fertilized in the lab with sperm
- The resulting, viable embryo is transferred to the uterus
If you are a candidate, donor eggs can be fertilized using your partner’s or a donor’s sperm, and pregnancy can be pursued using your uterus or a surrogate’s, depending on what’s right for your situation.
Donor Embryos
- If you become infertile after treatment, one option is using a donated embryo created from a donated egg and sperm.
- The embryo is then transferred to your uterus or to a surrogate’s, depending on what’s best for your situation
Other Reproductive Options
There are several meaningful ways to grow your family after breast cancer, including:
