Fertility Issues with Ovarian Cancer
Many treatments for advanced ovarian cancer can impair fertility, or the ability to have biological children. There may be ways to preserve (save) your fertility, though these may have to be done before you start treatment.
Fertility can be affected by cancer treatment in a variety of ways. If you are diagnosed with ovarian cancer and are interested in preserving your fertility, talk with your doctor. Together, you can discuss the possible side effects of your treatments, as well as options to protect your fertility.
How does infertility occur with ovarian cancer treatment?
Surgery is a main treatment for advanced ovarian cancer. If your treatment requires one of your ovaries to be removed, it may impair your fertility. If your treatment requires the removal of both ovaries, this will cause infertility. If your uterus is removed along with the ovaries, there is also no place to carry a developing baby.1
Many chemotherapy drugs used to treat ovarian cancer can impair fertility. Some of these drugs destroy eggs. This can lead to post-treatment infertility even if your uterus was not removed and you have 1 remaining ovary.1
The risk of infertility can vary depending on what drugs are used, the dose, and your age at the start of treatment.1
Hormone therapies can also affect fertility by blocking hormones, causing early menopause. This can be temporary or permanent based on the specific treatment.2
Are there ways to preserve fertility?
Depending on your age at diagnosis and how advanced your ovarian cancer is, there may be ways to protect your fertility, if that is something you want. Talk with your oncologist and treatment team before making any decisions. Some methods to protect fertility may not be recommended for you, depending on your cancer and treatment options.
Egg and embryo freezing might be an option for you. This is usually done by a fertility specialist.
This process usually takes several weeks. It involves stimulating your ovaries to mature multiple eggs by hormone shots. You will be monitored with blood tests and ultrasounds. Once the eggs are matured, they are retrieved by a needle inserted through the vaginal wall. The eggs can be frozen and stored for future use, or they can be fertilized with sperm and frozen as embryos.1
The eggs or embryos can then be implanted in your uterus when you want to become pregnant. They can also be implanted in a surrogate’s uterus if your uterus was removed.1
Ovarian tissue freezing is another option, though it is still experimental. This method is when an ovary or pieces of an ovary are surgically removed. The tissue is then taken to a special laboratory and stored with the hope of re-implanting it into your body. Once implanted, the eggs in the tissue will then potentially mature and be released during ovulation.1
If your ovarian cancer has not spread beyond one ovary, fertility-sparing surgery may be another option.3
During surgery, the doctor will take biopsies of several places in the pelvic and abdominal cavity to make sure the cancer has not spread. If cancer is not found beyond one ovary, your doctor may leave your uterus and other ovary in place, preserving your fertility. This is usually only a possibility in early-stage ovarian cancers.3
Things to discuss with your doctor
Talk with your doctor about your fertility concerns as soon as possible after diagnosis, before treatment starts. Things you may want to ask your doctor include:1-3
- What is my prognosis or the projected outcome of my cancer?
- Do I have time to do any fertility-saving methods like egg or embryo freezing?
- Is it safe for me to undergo fertility preservation?
- Will it be possible for me to get pregnant or carry a baby after treatment for my ovarian cancer?
Even if it is not possible to protect your fertility, there are other ways of having children. Talk with your doctor about all of your possible options.