Women's options after cancer treatment

Sunday 1 May, 2016

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On this page: Natural conception | Donor eggs and embryos | Sophie's story | Key points

Related pages: Women's fertility and cancer treatmentWomen's options before 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 failure or early menopause.

Before trying to conceive, you may want to have your fertility checked, see assessing your fertility.

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 radiotherapy 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 ovarian failure 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.

Hormones may be given to prepare your body to receive the donor egg or embryo, and 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, laws about collecting donor information vary between states and territories. In most cases, donors are required to be open donors. This means they must provide their name, address, date of birth, medical history, including genetic test results.

By law, all donor-conceived people are entitled to access identifying information about the donor once they turn 18.

In some states and territories, a central register has been established to allow people under 18 to apply for non- identifying information about their donor parent. Other states and territories require the clinics to maintain the data.

If you’d like to use donor eggs or embryos, speak with a fertility counsellor or lawyer who can discuss the implications for donor-conceived children.

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 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 had 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."

Key points

  • If you have eggs, you may be able to conceive naturally. You might be advised to wait a certain period before becoming pregnant.
  • If you can’t use your own eggs but wish to become pregnant, you may use donor eggs or embryos. You may also consider choosing a surrogate to carry your embryo or a donor embryo for you.

Reviewed by: Prof Roger Hart, Medical Director of Fertility Specialists of Western Australia and Professor of Reproductive Medicine, School of Women’s and Infant Health, University of Western Australia, WA; Dr Antoinette Anazodo, Paediatric and Adolescent Oncologist, Sydney Children’s and Prince of Wales Hospitals, Director of the Sydney Youth Cancer Service, NSW; Brenda Kirkwood, 13 11 20 Consultant, Cancer Council Queensland, QLD; Dr Michael McEvoy, Director of Clinical Services, Flinders Fertility, SA; Eden Robertson, Research Officer, Behavioural Sciences Unit, Sydney Children’s Hospital, NSW; Kayla Schmidt, Consumer; A/Prof Kate Stern, Head of Fertility Preservation Service, The Royal Women’s Hospital and Melbourne IVF, Head Endocrine and Metabolic Service, Royal Women’s Hospital and Clinical Director, Melbourne IVF, VIC; and Prof Jane Ussher, Centre for Health Research, Western Sydney University, NSW.

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