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Women's options after cancer treatment

Fertility options after cancer treatment may be limited. Your ability to become pregnant may depend on the effects of cancer treatment on fertility, your age and whether you have been through premature ovarian insufficiency or early menopause.

Before trying to conceive, you may want to have your fertility checked. See Assessing fertility after treatment.

If you harvested and stored eggs or embryos, you may choose to use them after treatment is finished. If your ovaries are still functioning after treatment ends, it is possible to freeze eggs or embryos then.

Natural conception

Some women are able to conceive naturally after finishing cancer treatment. This will only be possible if your body is producing eggs and you have a uterus. Your medical team will do tests to assess your fertility and will encourage you to try for a baby naturally if they think it may be possible to fall pregnant.

Women who have had chemotherapy or pelvic radiation therapy are at risk of sudden menopause, even after periods resume. If menopause is permanent, it means you will no longer be able to conceive naturally.

If you would like to try to fall pregnant naturally, speak with your cancer specialist first. You may be advised to wait between six months and two years before trying to conceive. The length of time will depend on the type of cancer and the treatment you had.

Donor eggs and embryos

If you have premature ovarian insufficiency after cancer treatment, using donor eggs or embryos may be the only way for you to try for a pregnancy. These options are available to women with a healthy uterus who can be pregnant, although there may be an age limit of about 51.

There are several steps to this process. The first involves taking hormones to prepare the lining of your uterus to receive the donor egg or embryo, and then until the pregnancy is viable. For this reason, women who have a hormone-sensitive cancer may not be able to carry a donor egg or embryo. If you'd like to consider other options, see Other paths to parenthood.

Finding information about the donor

In Australia, clinics can only use eggs and embryos from donors who agree that people born from their donation can find out who they are. This means that the name, address and date of birth of donors are recorded.

All donor-conceived people are entitled to access identifying information about the donor once they turn 18.

In some states, a central register is used to record details about donors and their donor-conceived offspring. Parents of donor-conceived children, and donor-conceived people who are over the age of 18, can apply for information about the donor through these registers. In other states and territories, people who want information about their donor can ask the clinic where they had treatment.

If you'd like to use donor eggs or embryos, discuss the possble issues for donor-conceived children with a fertility counsellor.

Using donor eggs

Most IVF units in Australia have access to donor eggs. You can also ask a family member or friend to donate eggs. Regardless of where the egg comes from, the donor completes blood tests, answers questions about their genetic and medical information, and goes through a counselling process.

When the egg is removed from the donor's body, it is fertilised by your partner's sperm or donor sperm to create an embryo. After a period of quarantine, the embryo is inserted into your uterus. See more information about the general IVF process and a diagram of how IVF works.

Egg donation is more expensive than standard IVF, as you may be paying costs related to the donor hormone stimulation process.

Using donor embryos

If you use a donated embryo, you can become pregnant without having a genetic relationship to the baby.

Your body will be prepared for pregnancy using hormones, then a thawed embryo will be transferred into your uterus through the IVF process.

Embryo donations usually come from couples who have gone through fertility treatments and have spare frozen embryos that they don't wish to use themselves. Embryos may be donated for ethical reasons (instead of destroying the embryos) or compassionate reasons (to help someone with infertility).

Sophie's story

"After I was diagnosed with chronic leukaemia, I still wanted to pursue fertility, so I discussed this with a fertility doctor.

"For the last couple of years, I've been on a drug that has done really well for me. As the cancer has been undetectable for the last four tests, we're hoping in the next few months to stop treatment and try again with a donor embryo.

"The fertility clinic couldn't really help us find donor eggs, so we went through a national egg donor organisation. We met our donor through one of their monthly get-togethers. We now have four embryos waiting for us to use.

"The organisation is for people at all points in the fertility process, from just starting through to going to meetings so their children can meet other children who were made through egg donation.

"The group also has an active support group forum. I learnt a lot about IVF through this forum and there's a lot of emotional support. There are quite a few people who have lost fertility due to cancer, but the majority are there due to non-cancer infertility.

"Because we've been through the process a few times, I'm a little circumspect in terms of committing to thinking I'll get pregnant. I want to make sure that I do all the right things so that if it doesn't happen, I know I've tried everything.

"One of the things I don't like about the situation is that I've got to do a lot of planning in case I get pregnant - what happens if I relapse, what treatments are available, would they induce early. Yet, I'm still nervous about whether I can get pregnant. The multiple goal setting has been quite difficult."

Tell your cancer story.

Key points about women and fertility

Fertility and cancer treatments

  • Treatments may cause acute ovarian failure, permanently or temporarily, or premature ovarian insufficiency (early menopause), which is permanent.
  • Chemotherapy is drug treatment that can damage the eggs in the ovaries.
  • Radiation therapy, given externally or internally, may damage the reproductive organs and cause infertility or future miscarriage.
  • Surgery could remove the reproductive organs or cause scarring that impacts fertility.
  • You will be advised to avoid becoming pregnant during cancer treatment and for a period of time afterwards.

Fertility options before cancer treatment

  • In-vitro fertilisation (IVF) uses hormone stimulation to develop eggs or embryos, which are collected, fertilised (if possible) and frozen.
  • Ovarian tissue is removed and frozen until needed, and then it's re-implanted. There have been over 100 births to date.
  • Some operations will spare your reproductive organs.
  • Hormone treatments, known as ovarian suppression, may help to protect your fertility.

Fertility options after cancer treatment

  • If you have eggs and a uterus, you may be able to conceive naturally.
  • If you can't use your own eggs, you may use donor eggs or embryos. You may also consider choosing a surrogate to carry your embryo or a donor embryo for you.

Expert content reviewers:

Dr Yasmin Jayasinghe, Paediatric Gynaecologist, Royal Children's Hospital Melbourne, Co-chair Fertility Preservation Taskforce, Melbourne, and Senior Lecturer, Department of Obstetrics and Gynaecology, University of Melbourne, VIC; Dr Peter Downie, Head, Paediatric Haematology-Oncology and Director, Children's Cancer Centre, Monash Children's Hospital, and Director, Victorian Paediatric Integrated Cancer Service, VIC; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland; Aaron Lewis, Consumer; Pampa Ray, Consumer; Dr Sally Reid, Gynaecologist, Fertility SA and Advanced Gynaecological Surgery Centre, Visiting Consultant, Women's and Children's Hospital, and Clinical Senior Lecturer, School of Paediatrics and Reproductive Health, The University of Adelaide, SA; A/Prof Kate Stern, Head, Fertility Preservation Service, The Royal Women's Hospital and Melbourne IVF and Head, Endocrine/Metabolic Clinic, Royal Women's Hospital, and Co-chair, AYA cancer fertility preservation guidance working group, VIC.

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