Can I get pregnant after breast cancer and when?
Some women can and do become pregnant after breast cancer, but because not enough studies have been done on this subject women should talk to their doctors if they are considering becoming pregnant. It is important to realize that certain cancer treatments can affect one's ability to bear children, and careful thought and planning is necessary to preserve fertility before and during treatment.
There are some clinical issues to consider when thinking about pregnancy after breast cancer:
- Estrogen receptor status of cancer cells – If cancer cells were estrogen-receptor positive, it may be riskier to get pregnant. With the hormonal surges associated with pregnancy, both estrogen and progesterone, it can be possible for dormant cancer cells to become active.
- Impact of chemotherapy on ovaries – At birth, every woman is born with a full complement of eggs in her ovaries to last a lifetime, expending one each month with her menstrual cycle. However, chemotherapy can damage ovaries in a variety of ways. Even if you didn't experience menopause, chemotherapy may kill some eggs completely, or may have damaged your remaining eggs, so they may be incapable of fertilization or may cause genetic defects. To some extent, a fertility specialist can determine the quality of your eggs and whether you have a chance at a successful pregnancy. Treatment may not put you into menopause immediately, but it could happen earlier in life than without a treatment history.
- Year of survival – While there is some debate, some oncologists recommend that you wait until you are past your five-year survival mark to consider pregnancy due to the impact it may have on your body. Others recommend waiting only two years.
- Limited fertility options – You might be unable to get pregnant the natural way, for a variety of reasons, some of which may have nothing to do with your cancer history. But as a cancer survivor, your options for fertility treatments may be more restricted, as many fertility programs include significant hormone stimulation.
- Extended Treatment – Some women require additional hormonal therapy after treatment, such as five years of Tamoxifen, which can further delay pregnancy. Speak with your doctor about the possibility of taking a break from Tamoxifen to have children.