If you’re asking that question, you’re not being unrealistic or losing focus on your care. Certain cancer treatments can affect your ability to conceive in the future, and while fertility may not feel like the most immediate concern, the timing matters. Egg freezing offers a way to preserve future family-building options, but it’s typically something that needs to happen before treatment begins. That’s why having the conversation early, even if you’re unsure about wanting children someday, can make a meaningful difference.
In honor of Breast Cancer Awareness Month, we’re breaking down what the research says about egg freezing before breast cancer treatment: what’s possible, how quickly it can happen, what we know about safety, and what to ask your care team.
The short version
- Some cancer treatments, especially chemotherapy, can reduce ovarian reserve and affect future fertility. The risk varies depending on your age and treatment plan.
- Egg freezing can often be completed in about two weeks and can start on any day of your period. Studies have found little to no delay in starting chemotherapy.
- Many women can pursue pregnancy after breast cancer treatment. Timing is a conversation to have with your oncologist.
Why does fertility preservation get missed?
Roughly 26,000 to 27,000 of new breast cancer diagnoses in the U.S. each year are in women 45 and younger. A national study of young women newly diagnosed with breast cancer found that about 60% had discussed fertility with their doctor. However, among those concerned about their fertility, only 22% pursued fertility preservation. Researchers point to barriers like cost, access, lack of referral, and uncertainty.
The American Society of Clinical Oncology (ASCO) says counseling about infertility risk and referral to fertility preservation care should be universal for every young person with cancer. The goal of this article is to make sure you have the information to ask for it.
Questions to ask your care team
If you’re considering fertility preservation after a cancer diagnosis, knowing what to ask can help you better understand your options and feel more confident about your next steps. Here are a few important questions to discuss with your care team:
- Which parts of my treatment plan could affect my fertility, and how much?
- How quickly can I see a fertility specialist? Can we start this week?
- Given my tumor type, which stimulation protocol do you recommend, and why?
- Should I consider embryo freezing instead of, or in addition to, egg freezing?
- Is ovarian suppression during chemotherapy right for me?
- What would pregnancy after treatment look like for my cancer, and when could we revisit it?
What are my fertility preservation options?
- Egg Freezing. This process involves retrieving multiple eggs and freezing them for storage. This allows you to store your eggs for potential use in the future. Egg freezing doesn’t require a sperm source, preserving more flexibility and autonomy in family planning.
- Embryo Freezing. Eggs are fertilized with sperm before freezing, which commits you to a sperm source now. This makes embryo freezing a suitable option if you’re in a committed relationship with a partner you plan to build a family with. Embryos can also be genetically tested through PGT before a future transfer.
- Ovarian suppression during chemotherapy. Certain medications, such as goserelin, can temporarily reduce ovarian activity during chemotherapy, potentially helping protect ovarian function. One study found that just 8% of women who received ovarian suppression experienced ovarian failure, compared with 22% who received chemotherapy alone. While this approach may help reduce the risk of ovarian damage, it doesn’t guarantee future fertility and is generally considered an additional option rather than a replacement for egg or embryo freezing.
How can cancer treatment affect your eggs?
Some cancer treatments, chemotherapy in particular, can damage the ovaries and reduce the number of eggs you have remaining. The impact varies depending on your age, the medications used, and your individual treatment plan.
Research shows that while ovarian function may recover after chemotherapy, egg supply doesn’t always recover along with it. Even if your periods return, your ovarian reserve (the number of eggs you have remaining) may be significantly lower than before treatment.
This is why timing matters. Understanding how your treatment could affect your fertility before it begins gives you the opportunity to explore options like egg freezing while they’re still available. Your oncology and fertility care teams can help you understand your individual risks and what makes sense for you.
Will egg freezing delay your cancer treatment?
This is the most common concern we hear, and it is a fair one. When you’ve just received a cancer diagnosis, the last thing you want is to delay treatment.
Research shows that while ovarian function may recover after chemotherapy, egg supply doesn’t always recover along with it. Even if your periods return, your ovarian reserve (the number of eggs you have remaining) may be significantly lower than before treatment.
This is why timing matters. Understanding how your treatment could affect your fertility before it begins gives you the opportunity to explore options like egg freezing while they’re still available. Your oncology and fertility care teams can help you understand your individual risks and what makes sense for you.
Is egg freezing safe if you have breast cancer?
The medications used during ovarian stimulation temporarily raise estrogen levels, which raises an understandable concern for hormone-sensitive cancers. Fortunately, many protocols use medications like letrozole during the egg-freezing process to help keep estrogen levels lower.
Research on fertility preservation in breast cancer patients has been reassuring, with studies finding no increased risk of cancer recurrence among those who pursued fertility preservation.
While these findings are encouraging, every diagnosis is different. Your oncologist and fertility specialist can work together to determine whether egg freezing is appropriate for you and develop an approach that prioritizes your cancer treatment and overall health.
Can you get pregnant after breast cancer?
For many women, pregnancy after breast cancer is still possible. While certain treatments can affect fertility, a breast cancer diagnosis doesn’t necessarily mean you have to give up your hopes of having children in the future.
Research has shown encouraging outcomes for women who pursue pregnancy after breast cancer, including some who temporarily pause hormone therapy under medical supervision. However, the timing of pregnancy depends on your diagnosis, treatment plan and individual health.
For women who need several years of hormone therapy, egg freezing before cancer treatment may offer a way to preserve future family-building options. While your body continues to age, frozen eggs remain at the age they were when retrieved. This can be especially meaningful if pregnancy needs to be postponed for several years.
Your oncologist and fertility specialist can help you understand when pregnancy may be safe to consider and what options are available to you.
What if treatment has already started?
ASCO’s (American Society of Clinical Oncology) guideline notes that there can be a second window for fertility preservation after cancer treatment. It may not look the same as it would have before chemotherapy, and your ovarian reserve may be lower, but it is worth asking about before assuming the option is gone.
What are the next steps?
If you’ve recently received a breast cancer diagnosis and are considering preserving your fertility, timing matters.
At Onto Health, our team can help you understand your fertility preservation options and work alongside your oncology team to determine what’s possible within your treatment timeline. You don’t need to have made a decision about egg freezing before reaching out.
Don’t wait to start the conversation. Call (844) 994-ONTO or text us (312) 847-1831 today and let us know about your diagnosis and anticipated treatment timeline so we can help you take the next steps as quickly as possible.
