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The Right to Bear Children: Preserving Fertility in Women With Cancer

Although cancer risk is known to rise with age, the disease can strike people at any stage of life. Cancer patients of all ages tend to be highly focused on getting through cancer therapy, fighting the disease, and surviving cancer-free. But premenopausal women with cancer have an additional set of concerns. Each will be forced to ask herself the following questions: As a woman with cancer, do I feel the same way about having children as I did before I was diagnosed? Do I want to protect my ability to get pregnant at all costs?

Although cancer risk is known to rise with age, the disease can strike people at any stage of life. Cancer patients of all ages tend to be highly focused on getting through cancer therapy, fighting the disease, and surviving cancer-free. But premenopausal women with cancer have an additional set of concerns. Each will be forced to ask herself the following questions: As a woman with cancer, do I feel the same way about having children as I did before I was diagnosed? Do I want to protect my ability to get pregnant at all costs? What can be done to preserve my fertility through the arduous chemotherapy process? Are fertility treatments hard to endure? Are they effective? What are my chances of getting pregnant once I'm out of the woods? Is it worth the trouble?

Lynn Westphal, MD, Assistant Professor and Director of the Donor Oocyte Program at Stanford Reproductive Endocrinology and Infertility Center, is a leader in the field of fertility preservation. Dr. Westphal has worked with oncology teams to help a growing number of women conceive after cancer therapy. Below, she outlines women's options, both common and experimental.

What steps can a woman take to preserve her fertility before starting cancer therapy?
A woman's treatment options will depend on the type of cancer she has, the type of treatment she's going to receive, and how much time she has before starting treatment. If she's going to start therapy very soon, her only option may be a gonadotropin-releasing hormone agonist (GnRH), a medication that may ultimately preserve ovarian function by shutting down the ovaries during chemotherapy. Although unproven, it is believed that putting the ovaries to sleep during chemotherapy may actually protect them. Afterwards, ovarian function may return to normal or close to normal.
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