Thinking About Fertility and Your Future
Because reproductive health needs vary by diagnosis, this section is intended for people with stage 0–3 breast cancer.
If you are living with stage 4, metastatic breast cancer, you’ll find dedicated reproductive health resources in our MBC section.
The good news? You have options
Like many young adults, you may be thinking about your future and wondering how treatment might affect your fertility—the ability to become pregnant in the future. Navigating these decisions can be emotional and overwhelming, especially when you’re already facing a cancer diagnosis.
If having a child someday feels important to you, bring it up with your care team as early as possible. Talking to a fertility specialist, your doctor, and a social worker can help you understand what’s possible and how to best get there. While treatment may make pregnancy more challenging, many young adults have gone on to build families after breast cancer. You’re not alone, and support is here for you.
How Treatments Can Affect Your Fertility
Cancer treatments can impact your reproductive health, depending on the type, duration, and timing of care. Some treatments may temporarily disrupt your menstrual cycle, while others can cause long-term changes that affect your ability to conceive. The effects can vary widely from person to person.
Endocrine Therapy
If your breast cancer is hormone-receptor-positive, your treatment plan will likely include hormonal (endocrine) therapy, such as tamoxifen. These treatments don’t directly damage your ovaries, but they can make your periods irregular or temporarily stop.
Most people stay on hormonal therapy for 5 to 10 years. During that time, your fertility naturally declines with age. For example, if you’re diagnosed at 32 and complete 5 years of hormonal therapy, your fertility at 37 may be significantly lower.
Some people choose to pause hormonal therapy to try to become pregnant. While stopping early may slightly reduce the protective benefits of treatment, research offers encouraging news. A recent international study (called POSITIVE) followed over 500 people who paused hormonal therapy to pursue pregnancy. The study showed that doing so is safe in terms of cancer recurrence based on short-term follow up and many participants were able to conceive and deliver healthy babies.
More research is ongoing, so talk to your care team to find out if this option is right for you.
Chemotherapy
Chemotherapy can directly impact your ovaries and reduce fertility. Some types of chemotherapy are more damaging to the ovaries than others. While some people continue to have regular periods during chemo, many experience amenorrhea (when your period stops temporarily) or menopause (when it stops permanently).
After completion of chemotherapy, periods may return—but not always. The older you are, the more likely you are to experience permanent menopause or infertility after chemotherapy. Most current studies show a strong relationship between long-term amenorrhea and infertility. However, it’s important to know that:
- Having no period after treatment doesn’t always mean you’re infertile.
- Having a regular period doesn’t guarantee that your fertility is unaffected.
- Only a fertility specialist can help you understand your current fertility status and whether pregnancy might be possible.
If this matters to you, you’re encouraged to explore your options early and ask for support. You deserve care that honors both your health and your hopes for the future.
Your Fertility is Personal and so is Your Cancer
That’s why it’s important to talk with your doctor not just about your diagnosis and treatment options, but also about what fertility means to you. Plan ahead and ask whether there are steps you can take now to help protect the possibility of having a baby in the future.
