Fertility Issues

Although radiation, chemotherapy and surgery can save the lives of people with cancer, these treatments can alter their fertility. Years ago, physicians were mainly concerned with saving the patient's life, and preserving fertility was not considered a priority. Now, however, protecting fertility before or during treatment should be considered a critical part of the plan.

Fertility concerns should be discussed early in the disease process; however, not all women undergoing breast cancer treatment are concerned about being able to become pregnant.

Contraception options should be discussed with premenopausal women prior to initiating breast cancer treatment.

In addition, sexual functioning should be assessed prior to the start of chemotherapy in both premenopausal and postmenopausal women.

Women younger than age 35 are more likely to resume menstruation after chemotherapy, but this is not a good reflection of later fertility (Martz & Kirby, 2007).

The medication tamoxifen, given to estrogen receptor-positive patients to reduce the risk of recurrence, may cause birth defects if taken during pregnancy. The National Cancer Institute advises women to use birth control and to avoid getting pregnant while taking tamoxifen.

One of the best resources for health professionals and patients is the Fertile Hope organization. Fertile Hope is a national nonprofit organization dedicated to providing reproductive information, support, and hope to patients with cancer whose medical treatments present the risk of infertility. Visit Fertile Hope’s website to discover the latest advances in reproductive assistive technology for patients interested in preserving their fertility as well as other topics related to fertility and cancer.

Martz, C.H., & Kirby, K. (2007). Symptom management in breast cancer. In S.M. Mahon (Ed.), Site-specific cancer series: Breast cancer (pp. 105–130). Pittsburgh, PA: Oncology Nursing Society.