Many women who have had breast cancer go on to have children and some are even able to breastfeed. Retaining your fertility and your ability to breastfeed depend largely on the type of cancer you have and the particulars of your tumor. As a general rule of thumb, smaller, early-stage tumors are less likely to interfere with fertility and breastfeeding than larger, later-stage tumors.
Cancer treatments cause may women to stop menstruating temporarily. This is your body’s natural reaction to extreme stress and its way of trying to conserve energy for healing rather than reproduction. In most cases, menstruation resumes a few months after treatment stops. One study found about half of women under age 35 got their periods again after finishing chemotherapy. However, many women experience less frequent or erratic periods, while others never start menstruating again.
Radiation
Studies have found that radiation to the breast area does not decrease a woman’s ability to get pregnant or to bear a full-term baby.
Chemotherapy
Chemotherapy, however, can impact fertility, especially in women over the age of 40 who are approaching the normal age of menopause. While chemotherapy does not affect your eggs and ovaries, it has been shown to cause premature menopause in about 10% of women who were still menstruating when treatment began, The older the women were when they had chemotherapy, the greater their chances of developing permanent menopause. Most studies seem to indicate that a woman’s chances of reaming fertile after chemotherapy are greatest if: 1) She was young at the time of treatment (i.e. not close to the normal age of menopause); 2) She received a limited amount of chemotherapy; and 3) The drugs, cytoxan and methotrexate, were not part of her chemotherapy regimen.
If you are still planning to have children after treatment it is important that you discuss this with your oncologist. If he or she knows that fertility is a concern, the oncologist may be able to tailor your treatment to improve your chances of avoiding premature menopause. If your cancer is more advanced and require aggressive treatment which increases your risk of premature menopause, you may want to speak with an infertility specialist before starting treatment. There are a number of options available to you. You might want to consider having eggs extracted from your ovaries, and frozen to await implantation after your treatment is finished. This way if your ovaries do shut down permanently because of the chemotherapy you will still be able to give birth. Unfortunately, this method is extremely expensive and is often not covered by insurance
Many doctors suggest that women wait between 2 and 5 years after treatment before trying to get pregnant. Since most signs of the more aggressive types of breast cancer usually manifest themselves during this period, waiting allows you to be relatively certain that you will remain healthy during your pregnancy. This waiting period is particularly important for women who have suffered hormone sensitive forms of cancer, because recurrent cancers could be exacerbated by the hormonal fluctuations of pregnancy.
Women who are unable to wait a few years before becoming pregnant because of time constraints, should at least give their body’s one year to recovery from the impact of chemotherapy before facing the physiological stresses of pregnancy.
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