If you have been diagnosed with breast cancer, you are not alone. 1 in every 27 women in South Africa is diagnosed with breast cancer at some point in their lives. Many of these women are young and have not yet completed or even started their families. Some haven’t even decided if they want children yet.

Now you may be thinking that having kids would be the least of your worries if you had cancer, but 86% of women will survive having breast cancer and then life goes on. Having kids may cross your mind once the dust has settled, but by then it may be too late.

Breast Cancer Treatment

The treatment of breast cancer depends on how advanced it is and what type of breast cancer you have. It may involve just cutting out a lump, but in most cases, it involves chemotherapy and hormonal treatment as well, which can have a detrimental effect on your eggs.

There are many different types of chemotherapy and the type that is most effective against breast cancer is unfortunately also the type that is most dangerous to your eggs. If you are very young and have many eggs, you may be lucky enough to have a few left over after your treatment, but most women are put into a menopausal state after this type of chemotherapy as all of their eggs are destroyed.

On top of that, you may require hormone therapy after your chemo to keep your estrogen levels down for a couple of years. This may push you to an age when getting pregnant may be much trickier even if you have a few eggs left, due to their reduced quality.

Fertility Preservation Options

For this reason, it’s a good idea to preserve your fertility BEFORE you receive chemotherapy. You can do this in a couple of ways: 1) Freeze your eggs, 2) Freeze some embryos, 3) Freeze some ovarian tissue. The first two processes take about 2 weeks and involve giving yourself some injections in your tummy to stimulate all of the eggs available for that month to grow. After about 2 weeks we will remove the eggs under sedation and either freeze them or fertilize them with sperm to make embryos. Ovarian tissue freezing involves key-hole surgery (that can be done at the same time as your chemo port insertion) and is a good option for pre-pubertal patients or patients who do not have 2 weeks to wait before starting chemo. In most cases a 2-week delay will not affect the outcome of your treatment or the risk of recurrence in any way. All three of these options are safe.

Pregnancy After Treatment

So once you’ve completed your surgery, chemo and hormonal therapy and you are finally ready to get pregnant….aren’t the hormones during pregnancy going to bring your cancer back?? No. There is good evidence that getting pregnant after breast cancer will not increase the risk of cancer recurrence. You will probably have had to have a mastectomy so breastfeeding unfortunately wont be an option, but luckily formula fed babies are just as healthy as breastfed ones.

-Written by Dr Skye de Jongh