Family Planning and Fertility Options with Ovarian Cancer

Ovarian cancer and ovarian cancer treatment can affect your fertility. If you wish to have children or would like to have the option, speak to your doctor. These conversations can start as soon as you are diagnosed. There are many fertility options available. More options may be available to you the earlier you are in your treatment.1

Natural pregnancy may still be an option after ovarian cancer. Other options include cryopreservation or moving the ovaries to a different part of the body. You may involve the help of surrogacy or a donor. Foster care and adoption are also options.1

Natural pregnancy

Some women may recover from cancer treatment and do not experience fertility complications. Cancer teams often recommend that women wait 6 months to 2 years after completing treatment to conceive. This is because chemotherapy and radiation can damage eggs.1

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Waiting 6 months can reduce the likelihood of birth defects. The highest likelihood of cancer coming back is in the first 2 years. However, you should talk to your doctor about what timeframe is best for you.1

Cryopreservation

Before undergoing certain treatments, such as surgery, you can try cryopreservation. It is a way to freeze eggs, sperm, or fertilized embryos.1

Once you are in remission, the eggs, sperm, or fertilized eggs can be thawed. Your doctor can then fertilize the eggs with the sperm to produce embryos and implant them using in vitro fertilization (IVF). If you have frozen fertilized embryos, they can be directly implanted using IVF.1

Egg donors

After your treatment, you may find that you are still fertile. However, you may not have had the opportunity to freeze eggs or embryos. In this situation, you may use an egg donor. A friend or relative may choose to donate their eggs.1

You may also purchase donor eggs from an egg bank. These donors are extensively screened for sexually transmitted diseases and genetic disorders.1

You may also have the option of using donor embryos. In many cases, donor embryos come from couples who have used IVF and have extra frozen embryos. In most cases, women who use a donor embryo must get hormone treatments to aid with a successful pregnancy. If you are interested in this option, talk to your doctor about whether you can
safely take hormones.1

Ovarian transposition

One common treatment option for ovarian, cervical, or uterine cancer is radiation to the pelvis. This can damage the ovaries and eggs. If only 1 of your ovaries is affected by cancer, your doctor may be able to move the other ovary. It can be moved to a different part of your abdomen so it will not be affected by radiation.1

Ovarian transposition is usually done before starting radiation therapy. This is because the ovaries tend to shift back to their normal position over time.1

Frozen ovarian tissue

Similar to ovarian transposition, your doctor may be able to entirely remove your ovary before treatment. The ovarian tissue will be frozen using cryopreservation.2

Once your treatment is complete, the tissue can be implanted back into your body. Some common spots include your forearm, abdomen, or back into the pelvis. The eggs in your ovary can then mature until they are ready for IVF.2

This is procedure still experimental, and research is ongoing.2

Surrogacy

A surrogate is a woman who carries and births your baby for you. This may be an option if you are no longer fertile or if you are fertile but your uterus is not ready for a pregnancy. Traditional surrogacy uses your partner’s sperm and the surrogate’s egg. This can be done at home using an artificial insemination kit to place the sperm in the surrogate’s vagina.3

Full surrogacy is another option. It is more complicated as it involves IVF to place a fertilized embryo. This fertilized embryo is made of your egg and your partner’s sperm. However, it is much more expensive.3

Foster care and adoption

There are many opportunities to be a parent in other ways. The foster care system is a way to give a home to a child while their birth home is not suitable. This can be temporary but in some situations may lead to adoption.3

Adoption, whether domestic or international, may also be a choice. This is a permanent option where you take over guardianship of a child. Adoption agencies may have different rules. Most allow cancer survivors to adopt. However, they may request information from your doctor on your health. They may have you wait a certain amount of time after finishing treatment before you may adopt.3

What comes next?

Oncologists and cancer nurses are often aware that fertility is a concern in certain cancers. However, this is not always guaranteed. You may need to bring up your concerns or ask for a referral to a fertility doctor.1

It is also important to understand that there are risks to fertility treatment. Be sure to research the experience and success rates of the IVF or fertility center you may use. There is no guarantee of success. However, there is a great deal of support available. Reach out to your doctor with any questions or concerns.1

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