Fertility issues have been recognized of great importance for young women diagnosed with breast cancer and other malignancies during their reproductive years. Oncologists should be prepared to discuss the implications of chemotherapy on fertility with their patients as early as possible during cancer treatment planning or alternatively refer patients to reproductive specialists to discuss the probability of iatrogenic ovarian failure and possible fertility preservation options.

The most well-established methods for fertility preservation are embryo and oocyte cryopreservation. These procedures both require ovarian stimulation which usually takes two weeks from the beginning of the menstrual cycle to complete. Typically, there is a gap of 4–6 weeks between women undergoing breast cancer surgery and the commencing of chemotherapy, therefore often sufficient time is available to undergo ovarian stimulation.

For women with a partner, embryo cryopreservation after IVF is considered as an established fertility preservation method. It is routinely used worldwide for surplus embryos after infertility treatments and it has been used for more than 20 years. For single cancer patients without a partner, freezing mature or immature oocytes, although still experimental, is the only option.

 

By Dr. Zakwan Khrait

Specialist Reproductive Medicine And Infertility