What you need to know about fertility and cancer

A new cancer diagnosis is instantly life changing. There’s so much to process and juggle, especially as you’re mapping out your treatment plan. You may feel overwhelmed. But if you’d like to have children in the future, it’s also a good idea to talk to your doctor about your fertility early on.

“Often, people don’t think about it because starting treatment is more urgent,” says medical oncologist Eleonora Teplinsky, M.D. “Then, three years later, when they want to get pregnant, they have a lot of trouble.”

Many cancer treatments — such as radiation, chemotherapy, and surgery — can affect your ability to conceive. Some can even cause infertility. Plus, some people may not be able to safely carry a pregnancy for a few years after treatment.

There is a lot to consider, and it’s worth taking the time to do it. Here’s what to know — and what you can do now to help protect your fertility later.

1. You may need to bring up fertility with your care team

Don’t assume your doctor will bring it up automatically. More than half of cancer doctors who treat young women don’t talk about fertility at all. Why? One reason is that many oncologists (doctors who treat cancer) usually care for patients in their 50s or older.

Or they may just be more focused on treating your cancer. If your oncologist doesn’t ask, start the conversation yourself.

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2. Seeing a specialist is key

If you’re female, consider seeing a reproductive endocrinologist, recommends the American Society of Clinical Oncology. That’s a doctor who treats women who have trouble becoming pregnant. They’ll help you understand your options for getting pregnant after cancer. And they’ll talk with you about procedures that can help.

Depending on your age and overall health, options may include:

• Egg freezing. Before your cancer treatments start, your doctor will take eggs from the ovaries and freeze them. When your cancer treatments are over, your eggs can be thawed and fertilized with sperm in a lab. For men, sperm samples can also be frozen and saved for the future.
• Embryo freezing. Your doctor will fertilize your eggs with sperm in the lab to form embryos. Then the embryos will be frozen for future use.
• Ovarian shielding. During radiation treatments, a cover is placed over your ovaries and other reproductive organs.
• Ovarian transposition. This is a procedure in which your ovaries are attached to the wall of the abdomen, away from where radiation will be given. 

For men dealing with a cancer diagnosis, it’s a good idea to talk to a urologist about sperm banking. “Chemotherapy or radiation can change normal sperm count and quality,” says urologist Poone Shoureshi, M.D. “So can the dose, how long it’s given, and the location of the cancer.”

3. Timing is important

If you decide to use technology to stay fertile, get started soon. “For cancers affecting [female] reproductive organs, there’s usually time for egg freezing,” says Dr. Teplinsky.

It typically takes about three weeks, she says. But it all depends on your periods and how quickly you can get an appointment. Freezing sperm requires less coordination. Men can provide a series of samples, with several days between each collection.

4. Some procedures may bring extra costs

Fees vary for these procedures, according to the American Cancer Society. Not all insurance plans cover procedures like egg freezing. Contact the Blue KC Care team at 816-396-2060 to discuss your benefits and care options.

5. You don't have to navigate this alone

A cancer diagnosis can take a toll on your mental health. And its possible impact on your fertility can turn your life plans upside down. But help is available. Talk to your care team about finding a therapist or a support group who specializes in cancer.

Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association.