Family Planning with Ovarian Cancer

Reviewed by: HU Medical Review Board | Last reviewed: May 2021

Cancer treatment may impact a woman’s fertility (ability to have biological children). This is especially true with ovarian cancer.

Most women diagnosed with ovarian cancer are past their childbearing years. However, about 12 percent are 44 years old or younger. Depending on the stage of the cancer at diagnosis, there are some options to protect fertility.1

If you have been diagnosed with ovarian cancer and think you want to have biological children in the future, talk to your doctor about your wishes. It is important to talk about this before treatment. Together, you and your doctor can go over your options.

How is fertility impacted by ovarian cancer?

Surgery for ovarian cancer may mean removing 1 or both ovaries and fallopian tubes, as well as the uterus. If all of these organs need to be removed, biological pregnancy is not possible.2

If only one ovary is removed, it may be possible to protect fertility. However, this can depend on the next treatment steps and other factors.2

Radiation to the pelvis and some chemotherapy drugs can also impair fertility. Some treatments may damage the eggs and cause early menopause. Others may damage the uterus.3

Even if a person remains fertile after treatment, it is often impossible to know whether treatment may impair fertility or cause early menopause in the future.

Are there options for preserving fertility?

Methods to protect fertility vary depending on the specific type of ovarian cancer. It also depends on the types of treatment used.

For early-stage ovarian cancer, surgery that protects your fertility may be an option. This may include surgery to remove only one ovary. Another option includes taking tissue from the remaining ovary and freezing (cryopreserving) it. It may then be fertilized and transplanted into your uterus in the future. However, this method is not yet widely available.1

For advanced ovarian cancer, you will likely need more extensive surgery. Freezing eggs and embryos may be an option. However, this can be expensive and takes time to stimulate the ovaries to make more eggs. This may not be possible if you have advanced ovarian cancer.2

If your doctor has removed both of your ovaries but not your uterus, you may be able to do in vitro fertilization (IVF) with donor eggs. This is when a donor egg is fertilized with sperm from your partner or a donor. The resulting embryo is then placed into your uterus. Depending on your cancer treatment, you may have to wait a certain amount of time before starting this process.2

What other options are there?

Some women will not be able to preserve their fertility before treatment. Some may not take steps to protect their fertility for personal reasons. However, there are other ways to build a family after treatment for ovarian cancer. You may also choose to enjoy life without having children.

Surrogacy is when another woman (the surrogate) carries your baby through pregnancy for you. This can be done by insemination when your partner’s or a donor’s sperm is placed in the surrogate’s vagina.2

Another method uses an embryo created from your partner’s or a donor’s sperm and an egg that was harvested from you or a donor. The embryo is then placed inside the uterus of the surrogate.2

Adoption and fostering are also options. However, some adoption agencies require you to wait a certain number of years after treatment before you may adopt.2

Being unable to have biological children can be very emotionally challenging. Talk to your doctor about how you are feeling. There are many resources available to help you. You do not have to go through this alone.

Things to consider

Before you start treatment, talk to your doctor about your wishes surrounding your fertility. Find out what options are available, and talk about any concerns you have. You may also want to talk to a reproductive specialist, especially one who has worked with people with cancer.

There are many ways to build a family, and they are not always biological. Knowing more about the many options can help you make informed decisions going forward.

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