Cancer treatment can affect women’s ability to have children – a scary thought for women who were hoping to expand their families before learning they have cancer.

Surgery, chemotherapy and radiation, the three main ways to treat cancer, can cause infertility, Marshfield Clinic obstetrics & gynecology physician assistant Kendra Konitzer said.

But advances in medicine have made it possible to preserve fertility and for women to have children even if cancer treatment has affected fertility.

“Treating the cancer takes precedent for most women,” Konitzer said. “If a woman is concerned about her future fertility, the most important thing she should do is talk to her doctor up front and discuss her options.”

Harvesting eggs before treatment

Harvesting and freezing eggs to use later is an option in some cases. Some women have their eggs fertilized and the embryos frozen so they can become pregnant after treatment.

The harvesting process takes four to six weeks and must be done before cancer treatment, but waiting can be a difficult choice, Konitzer said.

“Women often can safely wait four to six weeks, but they usually want to start treatment right away,” she said.

Freezing eggs isn’t an option for some women with breast cancer. The procedure requires a high dose of estrogen that can cause the cancer to grow.

Preserving fertility during surgery, radiation and chemotherapy

Most gynecologic cancers involve surgery, so doctors know in advance whether fertility will be affected.

It’s often possible to preserve fertility for patients in their 30s or younger because tumors usually involve only one ovary, Konitzer said. The affected ovary is removed and the other is saved.

For women undergoing pelvic radiation, the ovaries can be moved away from the radiation field.

Certain combinations of chemotherapy drugs less likely to cause infertility are used when possible. The affects of chemotherapy also depend on the patient’s age, Konitzer said.

“A younger woman who receives chemo will have a better chance of being able to ovulate because she has more eggs in her ovaries compared to an older woman,” she said.

Options after treatment

Reproductive technology gives women options to have a child if cancer treatment has affected their fertility.

Patients who have harvested eggs but can’t carry a pregnancy may ask a close relative to be a surrogate. The baby would be the patient’s biological child.

Women also have alternatives other than having a biological child, like adoption.

Another option is to carry a pregnancy using an embryo donated by someone else.

“A lot of things are available today that weren’t available 30 years ago,” Konitzer said.