Many women who learn that they need chemotherapy become concerned about their fertility. They wonder if chemotherapy will affect their chances of becoming pregnant.

Unfortunately, a common side effect of chemotherapy is temporary or permanent infertility. This means you’re unable to become pregnant. The chemotherapy drugs used to treat breast and other cancers can have an effect on healthy organs, including the ovaries that store the eggs needed for fertility. Once the eggs are damaged, they’re lost forever. Your body doesn’t make new ones. Chemotherapy can also affect your body’s production of the hormones needed to become pregnant or maintain a healthy pregnancy.

Your age, the type of medication you take, and how much medication you receive will influence just how much your fertility is at risk:

  • Women who undergo chemotherapy before age 35 are more likely to become pregnant after treatment. Many women stop having menstrual periods during chemotherapy, but younger women often have their periods return soon after treatment is complete.
  • Certain chemotherapy drugs used to treat breast cancer are more likely than others to cause fertility problems. These include Carboplatin, Cytoxan, and Doxil. Studies have also found that Bevacizumab (Avastin) can cause ovarian failure, and some women’s ovaries never recover.

If you’re concerned about your fertility, there are certain steps you should take as early as possible.

Before Treatment

Before you begin your chemotherapy sessions, talk with your oncologist about your wishes to have children. Some things you may want to ask include:

  • Will my chemotherapy affect my chances of becoming pregnant?
  • Are there any options to protect my fertility before treatment begins?
  • How long should I wait after my treatment ends before I start trying to have a child?
  • Will getting pregnant affect my follow-up treatment plan after chemotherapy ends?

Some women choose to have procedures that can preserve their fertility before starting chemotherapy. If you would like to explore these procedures, ask your oncologist to refer you to a fertility doctor who will help you better understand your options, including:

  • Embryo freezing—After taking fertility drugs for about two weeks, your eggs are collected and fertilized with your partner/donor’s sperm in a laboratory. The embryos are kept frozen until you’re ready to become pregnant.
  • Egg freezing—After the eggs are collected, they’re frozen unfertilized and stored until you’re ready to become pregnant. Egg freezing is less successful than embryo freezing, but many young women choose this option if they don’t have a partner yet.

Be sure to ask your oncologist if any of these procedures will change how well the cancer treatment works. Or, if any of the procedures increase the risk that your cancer returns. Also ask your oncologist how long you can safely delay the start of your chemotherapy to explore these options and proceed with fertility preserving procedures.

The fertility doctor can perform tests before and after your chemotherapy to find out your chances of becoming pregnant. It’s also a good idea for your male partner to have fertility tests. The health of his sperm is most important in your ability to become pregnant.

Keep in mind that chemotherapy doesn’t cause infertility in all women. Some women still have menstrual periods and can become pregnant during treatment. Because many chemotherapy drugs can be harmful to an unborn baby, your oncologist will recommend the best and safest birth control method to use during treatment.

After Treatment

In most cases, it’s safe to become pregnant after treatment. Your oncologist will suggest how long you should wait after treatment before beginning a pregnancy. It can depend on the stage of your cancer and the type of drugs used.

Some oncologists suggest that women avoid getting pregnant within the first six months after chemotherapy sessions end. This gives time for any eggs that may have been damaged by the chemotherapy drugs to leave the body. Other oncologists think it’s a good idea to wait at least two to five years. If the cancer returns, it usually happens within this timeframe. If you’re pregnant when the cancer returns, your options for cancer treatment may be limited.

If you’re having problems getting pregnant after the waiting period ends, a fertility doctor can help with other procedures that can increase your chances of having a child.