Pregnancy After Cancer: What Are My Options?

As treatments for cancer have continued to improve, more and more patients are surviving and able to continue to live full lives thereafter. This is good news because patients that have family building goals are able to live to see their desires fulfilled. Nevertheless, cancer treatments often have a negative impact on a person’s fertility, preventing them from being able to build their families naturally. Fertility treatments are able to assist people to build their families despite fertility challenges. 

Together with oncologists, fertility specialists are able to assist cancer patients to preserve their eggs, sperm, ovarian tissue, testicular tissue, or even embryos prior to the start of cancer treatment. Once treatment is complete, cancer patients typically have to wait about two years before trying to build their families. This allows oncologists to track the efficacy of treatment, and observe for any signs of recurring cancer. So let us look into the options one has for pregnancy after cancer.

Natural Conception vs. Assisted Reproductive Technologies

There are many factors that affect whether or not cancer survivors are able to have children after treatment. Chemotherapy and radiation therapy have been known to impact ovarian reserve and damage DNA. As well, surgical procedures may cause scar tissue which could prevent fertilization from occurring. 

Some women may experience a return of their menstrual cycle, while others may not. The return of a menstrual cycle tends to occur in patients who are younger, but fertility testing will be required to determine if they can become pregnant. Depending on a patient’s age, the natural decline in the ovarian reserve could prevent them from having children after treatment. 

After treatment, patients will be advised to wait for about two years before beginning to try having children. Once the oncologist clears a patient for family building, the first step will be doing a fertility evaluation to determine if they can have children naturally, whether they have sufficient eggs in their ovarian reserve, whether the eggs are of good quality, whether their uterus is fit to carry a pregnancy to term, among other factors.

If a patient can carry a pregnancy to term, then they can use their previously frozen eggs, or embryos to do so. On the other hand if they cannot become pregnant or carry a baby to term, then they have an option of using their eggs or embryos with a gestational carrier. In this way, a person can still have a child who carries their DNA. 

Using Frozen Eggs or Embryos

Whether to use frozen eggs or embryos is a decision that would be determined at the point one wants to start building their family. There are pros and cons to freezing either eggs or embryos, based on thawing outcomes and a person’s personal life circumstances. Embryos have better cellular structure and are more sturdy than eggs, which are a single cell. As a result, embryos can be frozen longer, and when it comes to thawing, they have a better thawing success rate compared to eggs.  

A person’s life circumstances in terms of their relationship status is another factor that affects whether or not to freeze eggs or embryos. If a person does not have a partner, or is not in a long-term commitment, they may not be able to freeze embryos. In such a case, freezing their eggs gives them more flexibility in family building with the partner of their choice. On the other hand if a person had frozen embryos with their partner, but is no longer with their partner at the time they desire to build their family, there will be legalities around parental rights and responsibilities to navigate before using the embryos. 

IVF After Chemotherapy

IVF treatments after chemotherapy are no different than regular IVF treatments used to help people have children. If a person can carry a pregnancy to term, they would begin treatments to prepare their uterus for embryo transfer. There are several variations of the fertility treatment depending on whether they are using a male partner’s sperm or donor sperm, whether they are using their own frozen eggs or embryos, or if they are using frozen or fresh donor eggs.  

Egg Donation and Surrogacy as Alternatives

If a cancer survivor was not able to freeze any eggs prior to treatment, but they still desire to have children, it is possible to build their family using alternative means. It is possible that a person’s ovaries may have been negatively affected by treatment, but their uterus was not. In this case, a patient may consider having children using donor eggs together with their partner’s sperm or donated sperm. 

When the entire uterus has been negatively impacted by treatment, a surrogate may be considered. A surrogate could become pregnant using the patient's previously frozen eggs or embryos. As well, a surrogate could use their own eggs, serving in a dual capacity of both egg donor and surrogate to the pregnancy. As well, a person could use their own partner’s sperm or donated sperm for the surrogacy. 

Finding the Right Fertility Specialist

The right fertility specialist for cancer patients would be one who specializes in oncofertility. This specialist takes into consideration the type of treatment, the duration, and survivability in planning whether to preserve fertility as eggs, embryos or ovarian tissue. This specialist also supports patients in beginning their family building journey. To know more about whether you can become pregnant after cancer, and what your options for family building in light of cancer treatments are, contact Utah Fertility Center.  

FAQs

Can I get pregnant naturally after chemo?

It is possible to become pregnant after chemotherapy, however, this is relative based on the type of cancer, the treatment administered and the duration of treatment.

How long should I wait before trying to conceive?

While a two year period is typically recommended, it is possible to begin fertility testing after about one year. However, your care team will be better placed to advise you on how to proceed, based on your specific circumstance. 

Does IVF work after cancer treatment?

Yes. IVF does work after cancer treatment. A person’s care team would be best placed to determine how to proceed with the treatments, once a fertility evaluation has been conducted.  

Can I still use my frozen eggs after cancer?

Yes. The purpose of freezing eggs prior to cancer treatment is to have the option of having healthy eggs for family building, where cancer treatment would have negatively impacted the health of any eggs remaining in the ovarian reserve.