Pregnancy After Cancer: What Are My Options?

The road to parenthood after cancer is filled with many options. Due to the fact that cancer treatments may take a toll on a person’s reproductive system, it is usually recommended that a person who desires to build their family make arrangements before beginning their treatments. Primarily, this is done through fertility preservation, by either banking sperm, testicular tissue, eggs, ovarian tissue or embryos. 

Once the treatment is complete, one may have to wait for up to two years before trying to build their family. The reason for this is that some types of cancer are notorious for recurring, requiring additional treatments. At the same time, after treatment is done, in this two year window, a person’s fertility may be restored, where a woman may begin to have a regular menstrual period, or a man begin to produce sperm again. So let us look at the different ways cancer survivors can build their families. 

Natural Conception vs. Assisted Reproductive Technologies

Most people tend to lean toward natural conception and only turn to assisted reproductive technologies when natural conception is challenging. After cancer treatments, it is possible to conceive naturally. However it is important to note that a return of fertility is more likely in younger patients than older ones. For females, this is largely due to the fact that younger ladies have a higher ovarian reserve.

If a person’s fertility does not return to normal, the second best thing is to use assisted reproductive technologies to conceive. There are many ways that this can be done depending on the sex of the patient, their age, uterine health, among others. Conception through ART has been found to be successful particularly in overcoming fertility challenges arising in natural conception. ART options include intrauterine insemination (IUI), in vitro fertilization (IVF) and IVF with intracytoplasmic sperm injection (ICSI). 

Using Frozen Eggs or Embryos

There are benefits as well as challenges of using either frozen eggs or frozen embryos. This is largely dependent on your fertility testing. When it comes to ART, embryos have been found to be more viable than eggs. Embryos have more structure and tend to survive the thaw better than eggs. As well, frozen embryos when thawed have a higher success rate than thawed eggs. They can also be frozen for longer.

Decisions about using eggs or embryos is also dependent on the relationship status a person has. When single, a person may not have the option of freezing embryos unless they use donated sperm. As well, should a couple split after freezing their embryos, there may be additional legal issues to navigate regarding parental rights. Freezing eggs tends to give women more autonomy compared to freezing embryos. Ultimately the decision lies with each individual. 

IVF After Chemotherapy

After chemotherapy it is possible for a person to undergo IVF treatments to become pregnant or begin building their family with their partner. However, fertility tests need to be conducted to determine what the impact of chemotherapy on their fertility has been. Once their fertility is assessed and it is determined that one can carry a pregnancy to term, the next step would be to prepare the uterus for pregnancy. IVF treatment will be done based on whether a person is using their own frozen eggs or embryos, whether they are using donor eggs, or whether they are using their partner’s sperm or donor sperm.  

Egg Donation and Surrogacy as Alternatives

In the event that chemotherapy has resulted in infertility and one cannot carry a pregnancy to term, there are alternative means of building their families. Egg donation can be used where one had not frozen their own prior to treatments. This is a viable option if the uterus has been assessed to be able to carry a pregnancy to term. In the case where egg donation is not a viable option, a person can use a surrogate and use their own eggs or embryos. As well, a surrogate can also donate their own eggs to carry a pregnancy to term on behalf of another as in the case of same sex male couples.

Finding the Right Fertility Specialist

When considering family building in light of cancer treatments the task can be daunting. It is vital to find the right fertility specialist to assist you in navigating the intricate details of pregnancy after cancer. If you have concerns about preserving fertility prior to cancer treatment, or you are ready to build your family now that you are cancer free, contact the team of specialists at San Diego Fertility. Our professional service is delivered with compassion and consideration to your family building goals. 

FAQs:

Can I get pregnant naturally after chemo?

This depends on several factors, including your age, type of chemotherapy, and how your ovaries were affected. While some women regain their natural menstrual cycles and can conceive naturally, others may experience permanent ovarian damage leading to infertility. Typically younger women (under 35) are more likely to regain ovarian function. If you had high-dose chemotherapy or radiation near the reproductive organs, it may cause early menopause. Usually, AMH (Anti-Müllerian Hormone) testing after treatment helps to assess ovarian reserve and fertility potential. However, if natural conception is not possible, options like IVF, egg donation, or surrogacy may help.

How long should I wait before trying to conceive?

Most doctors recommend waiting 6 months to 2 years after cancer treatment before trying to conceive. While this may seem like a long time to wait, it is necessary as some cancers have a higher risk of recurrence within the first few years. Ovarian function and hormonal testing are useful in determining when it would be safe to try. A fertility specialist and your oncologist are best placed to advise you on this. 

Does IVF work after cancer treatment?

Yes! IVF can be a highly effective option for cancer survivors, especially if they had frozen their eggs or embryos prior to treatments and if their uterus is healthy enough to sustain a pregnancy. As well, if a person has a low ovarian reserve but is still producing some eggs, it is possible to become pregnant. However, if ovarian function has been significantly affected, using donor eggs, or gestational surrogacy are still viable alternatives. 

Can I still use my frozen eggs after cancer?

Absolutely! If you had frozen your eggs or embryos before treatment, they remain viable for years. When you're ready to conceive, your frozen eggs can be thawed, fertilized, and implanted via IVF. Usually a fertility specialist will assess your uterine health and hormonal levels ahead of embryo transfer. However, if you sustained uterine damage from radiation or surgery, you may want to consider using a surrogate.

What are my options if I can’t get pregnant?

If natural conception and IVF are not possible, do not be discouraged, you still have options. You can use an egg donor if your ovaries are no longer producing viable eggs, or a surrogate if your uterus was affected by treatment. As well, you could adopt an embryo from another family or adopt an already existing child.