Some treatments for breast cancer can affect your fertility (your ability to have children).
Effects of breast cancer treatments on fertility
Once your cancer treatment has finished there is no reliable test to find out if you can still become pregnant. If your periods stop for a year or more, it’s more likely that your menopause will be permanent. If your menopause is permanent, you will be unable to get pregnant naturally.
If being able to have children is important for you, speak to your treatment team about fertility and family planning before starting treatment for breast cancer. Your oncologist may suggest that you see a fertility specialist to discuss your options.
Surgery or radiotherapy to the ovaries and fertility
Surgery and/or radiotherapy to the ovaries causes permanent infertility.
If a woman has her ovaries removed by surgery, or if she has radiotherapy to the ovaries, she will no longer be able to have children naturally.
Chemotherapy and fertility
Some chemotherapy drugs can cause a woman to become infertile.
Some women (usually women under 35 years) find that their periods return once chemotherapy finishes. However, this doesn’t mean that they are able to have children.
The effect of chemotherapy on fertility depends on a number of things, including the woman’s age and the type of drugs she receives. These effects can also vary between different women of the same age.
Hormonal therapies and fertility
Treatment with hormonal therapies (endocrine therapies) doesn’t cause infertility. However, a woman’s fertility may fall naturally while taking hormonal therapies. Most hormonal therapies for breast cancer are given for 5 years. After 5 years, a woman’s fertility will have fallen naturally because she’s older.
Although hormonal therapies for breast cancer can cause menstrual periods to stop, this doesn’t necessarily mean that a woman can’t become pregnant while taking hormonal therapies. Women who are sexually active while taking tamoxifen should use effective contraception if they don’t wish to become pregnant during this time.
Treatments for breast cancer may reduce fertility temporarily or permanently. However, this doesn’t mean it’s impossible to become pregnant during or after treatment.
Contraception after breast cancer treatment
Treatments for breast cancer may reduce fertility temporarily or permanently. However, this does not mean it is impossible to become pregnant during or after treatment.
Contraception containing hormones, such as the oral contraceptive pill (‘the pill’), implants or injections, should generally not be used after breast cancer. Therefore it’s recommended that you use non-hormonal forms of contraception, such as condoms, diaphragms, intrauterine contraceptive devices (IUDs) or male or female sterilisation if you don’t want to become pregnant. It’s still possible to catch sexually transmitted infections (STIs) after menopause. Condoms are the most effective way of protecting against STIs.
If you were pre-menopausal before breast cancer and you are sexually active, talk to a member of your health care team about suitable methods of contraception for you.
Although some breast cancer treatments can cause menstrual periods to stop, this doesn’t necessarily mean a woman can’t become pregnant during treatment. It’s important for women who are sexually active to continue to use contraception during and after breast cancer treatment.
There’s no evidence about whether or not it’s safe to take the oral contraceptive pill (‘the pill’) or use implants (etonogestrel implants) during or after treatment for breast cancer. Therefore it’s recommended that women use non-hormonal forms of contraception, such as condoms, diaphragms, intrauterine contraceptive devices (IUDs) or male or female sterilisation.
It’s still possible to catch sexually transmitted infections (STIs) after menopause. Condoms are the most effective way of protecting against STIs.
Breast cancer treatment and pregnancy;
Some breast cancer treatments are not recommended for women who are pregnant when diagnosed with breast cancer. Some treatments can also affect a woman’s ability to have children in future.
Treatment for breast cancer during pregnancy
If a woman is pregnant when she is diagnosed with breast cancer:
- it’s possible to have breast surgery with only a slight risk of miscarriage; the risk of miscarriage is lower after the first trimester
- radiotherapy is not recommended because it may harm the unborn baby; radiotherapy can be given after the baby is born
- chemotherapy is not recommended during the first trimester because it may harm the unborn baby; chemotherapy is often given during the second and third trimesters, when the risk of harm is lower
- hormonal therapy and trastuzumab (Herceptin®) are not recommended.
Pregnancy during treatment for breast cancer
It’s recommended that women do not become pregnant during treatment for breast cancer. Treatments such as chemotherapy and radiotherapy can harm the unborn baby.
Women should use contraception if it’s possible that they could become pregnant during treatment, even if periods become irregular or stop during treatment.
Effects of breast cancer treatment on fertility
Some treatments for breast cancer can affect a woman’s fertility. Once treatment has finished there’s no reliable test to find out if a woman will be able to fall pregnant in future.
Women who were planning to have children before their breast cancer diagnosis should speak to their oncologist before starting treatment for breast cancer. It may be possible to see a fertility specialist to discuss the available options.
