Pregnancy After Cancer: What Are My Options?

Cancer treatments have come a long way in variety of treatment options, as well as their effectiveness. As a result, cancer survivors are increasing each year, and it is expected that this will continue to be so. While this may be, cancer treatments can take a toll on a person’s health as well as their fertility. For those who desire to build families prior to their cancer diagnosis, all hope is not lost. Fertility treatments have also made strides in solving fertility puzzles, and helping people achieve their family building goals. 

Oncology specialists have teamed up with fertility specialists to assist cancer survivors in building their families after cancer treatment. This specialized area of fertility treatment is known as oncofertility. Cancer patients are requested to consider fertility preservation before beginning their treatments. Fertility preservation is done by cryopreserving healthy sperm or testicular tissue, eggs or ovarian tissue, or embryos. After treatment, patients are typically advised to wait for about two years before trying to conceive. 

Professional healthcare providers recommend this waiting window to ensure that the treatment was effective and the patient is cancer-free. There are some types of cancer than have a reputation of recurring, and it is for this reasons that doctor’s advise patients to wait. As well, the body during this period has a chance at fully regenerating, and this can restore soe people’s fertility, where women’s menstrual cycle is restored and men produce sperm again. That said, let us look at what options a person has if they are considering pregnancy after cancer. 

Natural conception vs. assisted reproductive technologies

After cancer, a woman may experience a menstrual cycle. This is a positive indicator as far as treatment success goes. However, even without cancer treatment, menstruation is not a sign that a person can conceive children naturally. Surgical treatments for example, could cause the fallopian tubes to be  blocked due to scar tissue. This results in the sperm never being able to reach the eggs to fertilize them. 

The ovarian reserve in older women is lower than that in younger women, and after cancer treatments, this could be even lower. Consequently, it is more likely that younger women have better chances of conceiving naturally more than older women.  Either way, if a cancer patient had undergone oncofertility treatments, then they can use assisted reproductive technologies (ARTs) to facilitate their family building.
 

Prior to trying to conceive naturally, or beginning any fertility treatments, a person will undergo a fertility evaluation to assess what effects cancer treatment may have had on their reproductive organs. Based on uterine health and other factors such as age, a treatment plan can be determined. Some people may be able to carry a pregnancy to term, while others may not. Those who are will likely use treatments such as intrauterine insemination (IUI), in vitro fertilization (IVF), and IVF with intracytoplasmic sperm injection (ICSI). Those who cannot carry a pregnancy to term may use their eggs or embryos in surrogacy. 

Using frozen eggs or embryos

There are a variety of benefits and challenges of both but their use is dependent on the results of your fertility testing and family building goals. While cyropreservation can be done for both eggs and embryos, frozen embryos tend to have better outcomes than frozen eggs. The reason for this is that embryos are not singular cells, they have more structure and so tend to freeze and thaw better than eggs as a result. Embryos can also withstand cryofreezing for longer than eggs can. 

Another aspect considered in deciding whether or not to use eggs or embryos is a person’s relationship status. A single person is likely going to rely on donated sperm for fertility therefore they may not have the option of freezing embryos prior to their treatment. Family building goals prior to cancer may change after treatment whereby a couple who had frozen embryos end their relationship. This would add a layer of legal considerations such as parental rights, that have to be established before the embryos can be used. For the most part, freezing ones eggs gives greater autonomy in decision making after cancer treatment. 

IVF after chemotherapy

IVF treatments after chemotherapy can be done to help people to build their families. If after fertility has been assessed and determined that a person can carry a pregnancy to term, a treatment plan would be determined. Typically, treatments would begin by preparing the uterus for embryo transfer. If a person is using eggs, they would need to be fertilized. As well, IVF treatment would vary depending on  whether someone is using their own eggs, or embryos,  frozen or frozen donor eggs, donor sperm or their partner’s sperm.  

Egg donation and surrogacy as alternatives

For cancer survivors whose fertility has been negatively impacted by treatment, there is still hope for family building using alernative means. Some options are using donor eggs where a patient had not preserved their own prior to treatment; using donor eggs where a patient’s ovaries are impacted by treatment, but their uterus is not; transferring an embryo in the uterus of a surrogate, either from a freshly fertilized egg, or a previously frozen embryo; using the surrogate’s eggs as donor eggs and fertilizing them with sperm from the patient’s partner; or using the surrogate’s eggs as donor eggs and fertilizing the with donor sperm.

Finding the right fertility specialist

Finding the right fertility specialist is crucial for cancer survivors who still desire to build their families. A specialist with expertise in oncofertility is best placed to support you through both fertility preservation before cancer treatment and fertility treatment thereafter.   If you have any further queries of concerns regarding oncofertility and pregnancy after cancer, contact the fertility experts at Dallas IVF. Our compassionate team is available to help you through your family building journey. 

FAQs

Can I get pregnant naturally after chemo?

Pregnancy after chemo depends on the type of cancer, the type of treatment, how aggressive treatment was and the duration. As well a persons fertility prior to treatment and their age are additional considerations to make.

How long should I wait before trying to conceive?

Typically, a waiting period of six to 12 months is recommended, in order to ensure that the body is completely free of cancer. Fertility tests would be conducted to determine the condition of the reproductive organs after cancer treatment. Your fertility and oncology care team will advise you based on your circumstances. 

Does IVF work after cancer treatment?

Yes. IVF is a highly effective treatment when it comes to post cancer family building. After fertility testing is one, treatment options are presented and decided upon based on the patient’s family building goals and if they had undergone any fertility preservation prior to treatment.  

Can I still use my frozen eggs after cancer?

Your frozen eggs are still viable after cancer. Cryopreservation is by far the most effective way of preserving a person’s fertility, with higher thawing success rates. When you are ready, your uterus will be prepared, the eggs will be thawed and fertilized, and the embryo transferred into your uterus.