Fertility issues after cancer treatment
Dr P Raghu Ram and Dr S Vyjayanthi
Options for preserving fertility following treatment are limited as damage to the ovaries has already occurred. For those women whose cycle returns, it may be possible to have pregnancies after breast cancer treatment. However, for some this may not be possible.
Egg donation: It may be possible to get pregnant by using eggs donated by other fertile women. This procedure involves taking hormone replacement therapy (not fertility drugs) to prepare the womb, prior to replacing embryos.
Fertility issues after treatment
It is difficult to predict precisely how fertility will be affected to each patient by cancer treatment. Generally speaking, a woman should assume that she could still get pregnant unless one has not had a period for at least a year (over 40 yrs) or two years (under 40 yrs) after completing breast cancer treatment. If periods haven’t started, one may still be producing eggs and could still become pregnant.
To check if a woman’s ovaries are working, the specialist will not only look at whether periods have started again but also monitor whether one has any menopausal symptoms. A series of blood tests to monitor the follicle stimulating hormone (FSH) may be taken.
An ultrasound scan of the ovaries may also be helpful but this needs to be performed in a specialist centre.
It may not be possible to find out straightaway after treatment has finished if a woman is still fertile. For example, one may have to wait three to six months after chemotherapy before blood levels can be tested.
(This column will continue next week. Dr Vyjayanthi is the HOD and consultant fertility specialist at KIMS Fertility Centre. Dr Raghu Ram is director and consultant oncoplastic breast surgeon at KIMS-Ushalakshmi Centre for Breast Diseases)
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