Advances in cancer treatments have given better results for many women diagnosed and treated
for cancer. Some of these cancer treatments can harm the ovaries, and can make the ovaries shut
down or stop working. This “shut-down” may last for a short time or it may be forever. Women
may no longer be able to have children (infertile).
Will I be infertile after cancer treatment?
1. Many things affect fertility following treatment for cancer. Some of these are:
ξ A woman’s age at the time of treatment
ξ The dose and type of chemotherapy medicines used
a) Chemotherapies that are the most likely to cause infertility include:
Cyclophosphomide, chlorambucil, melphalan, busulfan, nitrogen mustard or
b) Chemotherapies that might cause infertility include: Cisplatin and Adriamycin
c) Chemotherapies that are unlikely to cause infertility include: Methotrexate, 5-
fluorouracil, bleomycin, actinomycin D, vincristine
ξ Whether radiation therapy is used, as well as the dose and location of radiation in the
pelvis is most toxic to ovaries.
2. Some cancer treatments can make carrying a pregnancy more difficult or impossible. You
may need to have:
a) Hysterectomy (removal of the uterus and the cervix)
b) Radiation to the uterus
c) Need for treatments that block estrogen (to treat hormone-receptor positive breast
cancer) such as tamoxifen
Are there ways for women to preserve fertility before beginning treatment for
Yes, they include:
ξ Freezing embryos (eggs fertilized with sperm)
ξ Freezing mature eggs (eggs stimulated with medicine leading to ovulation) that can be
fertilized in the future
ξ Experimental procedures for freezing immature eggs / pieces of tissue from the ovary
ξ Treatments to try and protect the ovaries from damage due to chemotherapy
Embryo freezing (cryopreservation)
ξ Embryo freezing needs in vitro fertilization (IVF) medicines and procedures.
ξ How it works: Hormones are given to stimulate the ovaries to make follicles that help
eggs mature. The eggs may be able to be fertilized by sperm.
ξ Embryos come from eggs fertilized by sperm and grow from one cell to many cells,
which are then frozen and stored for later use / to put in the uterus.
ξ Current information shows that this has the best chance of future pregnancy.
Insurance may not cover this option, which can be costly. There are grants
available, especially for cancer patients that can help offset the costs.
Embryo preservation requires sperm, which can come from a partner, friend, or
A complete IVF cycle takes anywhere from 2-6 weeks, depending on timing of
the last period.
Egg freezing (cryopreservation)
ξ Best choice for women that do not have a male partner or do not want to use donor sperm
ξ Egg freezing requires in vitro fertilization medicines and procedures.
ξ Hormones are given to stimulate the ovaries to make follicles that help eggs mature.
ξ These eggs are removed in an outpatient procedure and frozen on the same day.
ξ In the future, when the patient is ready to pursue pregnancy, the eggs are thawed and
fertilized by sperm to create embryos to put in the uterus.
Experimental ovarian tissue cryopreservation
ξ This procedure involves freezing parts of a woman’s ovary, which can be put back into
the body after cancer treatments are completed
ξ Success rates with ovarian tissue cryopreservation are low. It should only be considered if
the other options are unavailable.
Treatments to try to protect the ovaries from chemotherapy
ξ A recent study suggests giving a medicine to turn off the ovaries (leuprolide or goserelin)
may help to protect the ovaries from damage due to chemotherapy. Women who had their
ovaries “turned off” were more likely to have periods resumed or have a successful
pregnancy after cancer treatment. This treatment seems safe in hormone-receptor
negative breast cancer, but has not yet been studied in hormone-receptor positive breast
ξ This medicine can be given by your cancer team during chemotherapy.
Not everyone will have the time to go through cryopreservation procedures, especially if
chemotherapy / radiation is urgently needed. This can take a few weeks to complete. During this
time, you will be taking medicines / hormones to help your ovaries mature more than one egg.
Each woman has a different amount of immature eggs (ovarian reserve). Finding out what your
reserve is will help decide which treatment to use. There is usually time to try for only one IVF
If a pregnancy would not be safe after cancer, a surrogate, or gestational carrier, may be needed.
If you are interested: Set up an appointment with Generations Fertility Care Clinic to talk about
options. This appointment can be made within a week (or sooner!). Please ask to speak with the
financial counselor at the time of scheduling to review coverage and possible treatment cost
Generations Fertility Care Clinic (Generations), Monday – Friday, 7:00am – 4:30pm
608-824-6160 or toll free 1-888-474-3933
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 10/2015 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7811