Fertility and the possibility of pregnancy after cancer treatment are major quality of life concerns of many young women with breast cancer.  Before starting breast cancer therapy, patients should understand the options that may help maintain fertility. The patient should consider the possibility that she may have difficulty becoming pregnant and may need reproductive assistance or she may not be able to become pregnant after treatment. Fertility is influenced by many factors such age, prior fertility problems, type of chemotherapy, type of hormonal therapy, weight and smoking history. An assessment of fertility options before treatment will help determine a realistic perspective for fertility and pregnancy after breast cancer therapy ends.

Important considerations: 

An RE is a physician who specializes in helping patients with fertility concerns. An RE can work with the oncology team to provide the patient with important information about her prospects for maintaining fertility, available assisted reproductive technology (ART) and cost considerations. For help locating an RE, visit the American Society for Reproductive Medicine's (ASRM) website.

Options BEFORE treatment include:

• Embryo Cryopreservation - most widely used Fertility Preservation method, and is considered the best option for a patient who has an available sperm source.  The limitations for use with oncology patients include treatment delay (between two to six weeks, one menstrual cycle), the potential risk of estrogen exposure for those patients with estrogen-sensitive tumors, and the need for a male partner or other sperm source.

• Oocyte (Egg) Cryopreservation - provides patients with the combination of the least invasive procedure and most options in the future.  Although oocyte cryopreservation is still considered experimental, its success rate continues to increase.  This method has similar limitations to embryo cryopreservation, with the exception of no sperm source being required at the time of freezing.
• Ovarian Tissue Cryopreservation - can be quickly performed by an RE and does not delay treatment.  A piece of the ovary is removed and frozen for the patient's future use in an ART procedure.  This method is also still considered experimental, but multiple births have occurred.  Ovarian tissue cryopreservation is the main Fertility Preservation option for pre-pubescent girls.

Options AFTER treatment include donor egg IVF, surrogacy or adoption.

For detailed information on the above Fertility Preservation options, including costs, please view our previous Fertility Preservation 101 issues.  View our Fertility Preservation 101 booklet online.

According to the American Cancer Society, more than 2,100 cases of invasive breast cancer in men are expected to be diagnosed in 2011.

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Resources:

ACS Male Breast Cancer Guide

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