Breast cancer and the desire to have children
Breast cancer is a shocking diagnosis for every woman. For women who want to have children, however, it poses a threat not only to their lives, but also to their chance of becoming a mother. Many breast cancer patients rightly ask themselves “Can I still have children?”. In this article we explain what measures can be taken to preserve the possibility of having children despite suffering from breast cancer. We also list helpful contact points.
Breast cancer and the desire to have children
Every year, around 70,000 women in Germany are diagnosed with breast cancer. This makes it the most common cancer in women — and it is rightfully feared. One in eight women in this country will be diagnosed with breast cancer during their lives. Many women have already come into contact with the disease through relatives, friends or acquaintances. The fear of passing on the genetics to suffer from this cancer is also great amongst patients and their relatives.
The diagnosis as a heavy burden
The diagnosis is painful in more than one way, especially for women in their reproductive age. In the past, cancer was practically synonymous with saying goodbye to the desire to have children: strong chemotherapies permanently damaged the ovaries and decreases fertility.
But there is good news too! The survival rate is increasing: Almost 90 percent of all patients are still alive five years after their diagnosis. Moreover, there are a number of methods available today to help cancer patients fulfil their wish for a biological child.
Chemotherapy: Effective, but they endanger fertility.
The purpose of chemotherapy is to stop the rapid growth of tumour cells. These cells are permanently damaged through the application of chemotherapeuticals . However, the damage cannot be limited to only tumor cells but also extends to healthy tissues. For example, in the area of the female reproductive organs, ovarian tissue can also be permanently affected. In consequence, the female cyclus can be persistently transformed. The risk of not even having a period after chemo is up to 68 percent.
Fertility despite a cancer diagnosis
So how can one’s fertility be preserved after cancer therapy? That is the crucial question. In order to answer it, many different factors need to be examined:
- Is the tumour hormone-dependent or hormone-independent?
- What cancer treatment is being considered?
- How old is the patient?
- What is the situation regarding the woman’s ovarian reserve?
Most breast carcinomas are hormone-dependent, i.e. the tumour-growthis stimulated by the female sex hormones oestrogen or progesterone.
As a result, a longer period of anti-hormonal medication is usually needed after surgery or chemotherapy. This reduces fertility. Therefore the desire to have children should be expressed to your doctor before starting cancer therapy.
Useful fertility-preserving measures for cancer
There are a number of methods to ensure that fertility is preserved before cancer treatment. These are, for example Cryopreservation of eggs. In this case, eggs are removed from the woman via a puncture to her ovaries before cancer treatment starts. These are then frozen in liquid nitrogen at minus 196 degrees Celsius. Before the — mostly unfertilised — eggs can be removed, the ovaries must be hormonally stimulated. After the cancer treatment has been successfully completed, the eggs can then be thawed, artificially fertilised via IVF and then reinserted. According to experts, the concern of patients with hormone-dependent breast cancer that ovarian stimulation also induces the growth of tumour cells is usually unfounded.
Cryopreservation of ovarian tissue is also an established method of preserving fertility nowadays. About half of an ovary is removed by laparoscopy and frozen. It can then be re-transplanted again at a later date.
It is also medically possible to use GnRHa. This bulky abbreviation stands for so-called gonadotropin-releasing hormone agonists, which — administered as a monthly or three-monthly injection — put the ovaries to “sleep” during chemotherapy. This is to protect the eggs by stopping them from maturing which makes them less vulnerable to chemotherapy. GnRHa is given before chemotherapy begins and during the rest of the treatment. After completion of the chemotherapy, the idea is that the paralysed ovaries will return to functional mode. Because this method has not yet been fully researched, it is carried out in combination with other fertility-preserving measures.
Medical Freezing: Subsidy from the health insurance companies
Cryopreservation in particular is a standardized method that has to be managed financially. However, statutory health insurance companies in Germany pay a proportion of the costs of fertility preservation measures for cancer patients. This includes medical freezing. The costs for the later, necessary artificial insemination are also covered on a pro-rata basis. It is best to ask your own health insurance company as early as possible to find out more.
Support for the desire to have children with breast cancer
Where can one turn for further information? Patients with breast cancer or other types of cancer who wish to have children should visit the FertiPROTEKT website. Here, gynecologists and reproductive physicians from Germany, Austria and Switzerland have joined forces to provide women in particular with advice on fertility-preserving measures prior to chemotherapy. This gives the topic of the desire to have children a special status, especially in oncology, which it did not have for decades because of the focus on eradicating cancer cells. A consultation with a specialist is advisable here.
The FertiOnco page of the University Hospital Basel is also helpful in selecting fertility-preserving measures. Here you will find more information on cancer and fertility and, in particular, an interactive decision tool.
Social freezing: success rates
What is the ideal age to freeze my eggs? This is an often asked question in the context of social freezing. A simplified answer would be that it is generally better to freeze at a younger age than at a later age. However, it is not quite that simple.
At Fertilly, we have made it our mission to accompany couples (homosexual and heterosexual) and singles on the way to fulfilling their child wish. In doing so, it is important to us to create transparency in the area of fertility services, to provide information and knowledge on the topics of pregnancy and fertility and to help you to find the most suitable Fertility Center. Through cooperation with first-class Fertility Centres and clinics in Europe, enquiries about Fertilly are given preferential treatment. This means that our patients avoid the usually long waiting times and get appointments more quickly.
If you would like more information about Fertility Centers, success rates and prices, please contact us using this questionnaire. We will advise you free of charge and without any obligation.
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