The journey through breast cancer is often marked by a series of complex emotions, challenges, and decisions. For many women, a significant concern is how breast cancer treatments might impact their family planning. As treatments advance and survival rates improve, it's essential to address the questions around pregnancy and reproductive health, providing women with the information and support they need to make informed decisions about their future. Understanding the interplay between breast cancer treatments and reproductive health is essential for providing women with comprehensive care that respects both their medical and personal aspirations.
According to WHO, approximately 2.3 million women are diagnosed with breast cancer each year worldwide, making it the most common cancer among women.1 Globally, breast cancer accounts for one in four of all cancers in women, a figure that underscores its widespread impact. Since 2008, the incidence of breast cancer has surged by over 20 percent, and the mortality rate has increased by 14 percent. These numbers not only reflect the growing prevalence of the disease but also hint at the diverse challenges faced by those undergoing treatment, including concerns about fertility and the ability to conceive post-recovery.
Most individuals diagnosed with breast cancer undergo a combination of treatments, which may include surgery, chemotherapy, radiation, and hormone therapy. Each of these has a distinct role in managing the disease, but they also come with potential side effects that can impact a woman’s fertility.
Chemotherapy, one of the primary treatments for breast cancer, works by targeting rapidly dividing cells, which, unfortunately, includes not only cancerous cells but also healthy cells in the ovaries. This damage to ovarian follicles can lead to a reduced ovarian reserve, making it more difficult for women to conceive. Studies have indicated that women treated with chemotherapy are at a higher risk of infertility compared to their healthy counterparts. The extent of the damage largely depends on factors such as the patient’s age, the specific chemotherapy drugs used, and the dosage. While younger women may have a better chance of ovarian recovery, the risk remains significant and should be discussed with healthcare providers before starting treatment.
Radiation therapy, another cornerstone of cancer treatment, can also have a profound effect on fertility, especially when directed toward the pelvic area. High doses of radiation can cause irreversible damage to the ovaries, leading to permanent infertility, while lower doses may result in temporary effects on ovarian function. The risk of damage is highest when radiation is focused on the abdomen or pelvis, which can affect the reproductive organs directly. Even when radiation is targeted elsewhere in the body, such as the chest, there is still a potential for reproductive health complications, particularly when combined with other treatments like chemotherapy.
Beyond the physiological effects, the emotional toll of breast cancer treatments on fertility should not be underestimated. The thought of infertility can add another layer of distress to an already challenging journey. However, it’s important to note that not all women undergoing breast cancer treatment will face infertility, and advances in fertility preservation techniques, such as egg or embryo freezing, offer hope for those who wish to pursue pregnancy after cancer treatment. However, before proceeding with the procedure, one must consult their oncologist and fertility experts to navigate the impact of individual therapy. By integrating reproductive health services into cancer care, healthcare providers can ensure that women receive comprehensive support that addresses their needs and desires for the future. This can involve early discussions about fertility, education on the potential impacts of different treatments, and referrals to specialists who can provide personalized advice.
Ultimately, the decision to pursue fertility preservation or future pregnancy is deeply personal, and every woman’s situation is unique. However, advancements in Assisted Reproductive Technologies (ART) have provided new hope, offering options such as egg or embryo freezing, ovarian tissue preservation, and in vitro fertilization (IVF). These technologies make it possible for many women to preserve their fertility before starting treatment, allowing them the opportunity to have biological children later. A holistic approach that respects and empowers women is essential, as is continued research into safer, more effective treatments that minimize the impact on fertility. As we raise awareness about breast cancer and its broader effects, it is vital to ensure that fertility and pregnancy are part of the conversation, offering clarity to those facing the complexities of cancer treatment.
(Article Courtesy: Dr. Kshitiz Murdia, CEO & Co Founder, Indira IVF)
