First Response®
LIVESTRONG Project Specialist

CANCER TREATMENT IMPACT ON ABILITY TO CONCEIVE
Q&A With Emily Eargle, Project Specialist

Emily Eargle brings to light the impact of cancer treatments on fertility and
family building options for cancer patients.

Q: Do cancer treatments cause infertility?

A: When facing cancer, survival is most important. However, you should know that the treatments used to fight your cancer may affect your ability to have children. Cancer treatments can cause infertility and premature ovarian failure. The following factors can influence a woman's risk:
  • Age at diagnosis or treatment
  • Pre-treatment fertility status
  • Type and dose of chemotherapy
  • Location and dose of radiation
  • Surgical area
Chemotherapy, radiation and surgery can all affect your reproductive system. In general, the greater the total dose of chemotherapy and radiation, the higher the chance for reproductive problems. Here is more information on a few of the treatments and their affect on fertility:

Chemotherapy
Chemotherapy can damage or destroy your eggs. Your age, the type of chemotherapy, and the dose of the medications can influence your risk. Certain chemotherapy agents are more damaging than others. Generally alkylating agents are the worst. The risk of infertility for some of the newer cancer medications may be unknown.

Radiation
Radiation can also damage your reproductive system if it is directed toward your pelvic area. For example, radiation to or near your ovaries or uterus can cause infertility, but radiation to your chest will not. Radiation to your pituitary gland or hormone-producing areas of your brain can also cause infertility by interfering with your normal hormone production. In addition, radiation to your pelvic area can cause uterine damage, which may make it difficult to maintain a pregnancy. The location and dose of radiation will influence your risk.

Surgery
Surgery that removes all or part of the reproductive system can cause infertility. Removal of your ovaries, uterus, cervix or other reproductive organs can cause infertility. The location and scope of surgery will influence your risk.

Bone Marrow & Stem Cell Transplants
Bone marrow and stem cell transplants generally involve high doses of chemotherapy sometimes combined with full body radiation. Therefore, these procedures present a high risk of infertility due to ovarian and uterine damage.
Not all cancer treatments cause infertility, but some do, so it is important to understand your individual risks. Fertile Hope provides a personalized risk calculator at http://www.fertilehope.org/tool-bar/risk-calculator.cfm. Talk to your oncologist to learn more.


Q: What family building options are available for cancer patients and survivors?

A: There are more family-building options for cancer patients and survivors available today than ever before. The average cancer patient has 2-6 weeks from diagnosis until starting treatments, which is often enough time to preserve your fertility. Knowing your risks, your fertility status and your options quickly is important for making timely, educated decisions. Here is a list of some of the options available today:

Before Treatment
  • Embryo Freezing
  • Egg Freezing
  • Ovarian Tissue Freezing
  • Fertility Sparing Surgery
  • Ovarian Transposition
During Treatment
  • Ovarian Suppression
  • Ovarian Shielding
After Treatment
  • Natural Conception
  • Assisted Reproductive Technologies
  • Using Frozen Embryos, Eggs & Ovarian Tissue
  • Some Fertility Preservation Options
  • Donor Embryos & Eggs
  • Gestational Carrier or Surrogacy
  • Adoption
Visit http://www.fertilehope.org/tool-bar/options-calculator.cfm a personalized options calculator.


Q: After cancer treatments, how do I know if I am fertile?

A: For women, several factors determine fertility. First, you may have hormonal tests such as FSH (follicle stimulating hormone) to gauge your ovarian reserve and reproductive capacity, the FIRST RESPONSE® Fertility Test for Women now allows you to gauge FSH levels in the privacy of your home with over 95% accuracy.
Second, you may have an ovarian ultrasound, which can also help gauge your ovarian reserve (the quantity and quality of your remaining eggs) and detect any damage from your cancer treatments. If fertility returns, it usually takes six months to one year. In some cases, it can take longer. Knowing your fertility status after cancer, can be empowering as the results of these tests can help you determine which parenthood options are right for you.


Q: Is it safe to get pregnant after cancer?

A: Research in this area is limited, but reassuring – pregnancy after cancer does not appear to cause or increase the risk of recurrence, even after breast cancer. Research also suggests that the birth defect rate of children born to cancer survivors is similar to that of the general public. Lastly, there does not seem to be an unusual cancer risk in the children of cancer survivors except in families identified with true genetic cancer syndromes, for example, inherited retinoblastoma.
Note: The aforementioned advice should not replace a visit with your doctor.
LIVESTRONG Project Specialist Emily Eargle, Project Specialist
Emily Eargle received her Masters of Science in Social Work from The University of Texas at Austin in Austin, Texas. Beginning her professional role as a counselor through the Communities In Schools program, she provided individual and group counseling to adolescents and young adults in a school setting. Through this position she gained experience specific to grief counseling, community engagement and development of educational materials. Her professional experience was enhanced through her role at United Way Capital Area where she was involved in new program research and development. Emily brings these skills to her current position as Navigation Project Specialist at LIVESTRONG. In this role, she coordinates operations and collaborative projects pertaining to navigation services for people affected by cancer, including the LIVESTRONG Fertile Hope initiative that is dedicated to providing reproductive information, support and hope to cancer patients and survivors whose medical treatments present the risk of infertility. She is also involved in program assessment and improvement for all navigation services. Her professional focus is on excellent community driven service development and delivery.

LIVESTRONG Cancer Navigation Services provide free one-on-one support in English and Spanish to anyone affected by cancer. For support, contact us toll free at 1-855-220-7777 or visit our website at www.livestrong.org/gethelp.

LIVESTRONG Fertile Hope does not endorse specific products or brands.