A look at the treatments that can impact your fertility and your options to preserve it
What Treatments for Breast Cancer May Impact My Fertility?
Not all cancer treatments impact fertility in the same way. Some treatments have minimal risk to fertility, while others are much more likely to have an impact. Chemotherapies classified as alkylating agents are associated with a higher risk to fertility than other types of chemotherapies. Oncologists and reproductive endocrinologists can help you determine what your personal risk to fertility may be based on your treatment plan and age.
Age is an important factor when determining your risk for infertility when beginning treatment for breast cancer. Women are born with all of the eggs they will ever have, and chemotherapy can significantly decrease that number of eggs. Generally, younger patients will have a higher ovarian reserve—a higher number of eggs—prior to starting treatment than older patients, so even if their egg count drops because of their treatment, it may not drop low enough to put them into menopause. Menopause is when the ovaries stop releasing eggs and menstrual periods stop. Patients may become menopausal earlier than they would have without cancer treatment, but they may still have many fertile years after completing treatments. An older but still premenopausal patient will have a naturally lower egg supply because of her age. When they begin chemotherapy, their egg count may drop to a level low enough to induce early menopause more quickly.