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POST-TREATMENT FEMALE FERTILITY
As a member of the Cancer Survivorship Community, you’ve officially graduated to the next chapter of your cancer journey. Congratulations! This is a huge milestone, and now we focus on you and the issues relating to your previous diagnosis and treatment. The main focus is to keep you as healthy as possible, and we will guide you about what specific ongoing medical follow-ups are needed. One follow-up is to see how treatment affected your fertility.

Cancer therapy affects every female patient’s fertility differently. The Fertility team can work with your Survivorship team to help determine your individual risk. If you are at risk of infertility, you may be able to save your ability to choose if you want children someday, no matter how, where, or when you received therapy.
If you did not undergo a fertility preservation option before your treatment began, you may still have the option now that your treatment is done.

In a woman’s body, all reproductive activity starts in the ovaries. When born, females are given a limited number of eggs that are housed in follicles in your ovaries. This is called your “ovarian reserve.” Throughout your lifetime, the ovarian reserve never creates any more eggs, so what you’re born with is what you get.
The ovaries have 2 main functions, produce hormones, and prepare and release the eggs. You need both of these to happen to get pregnant naturally. Your fertility “window” starts when your hormones start telling your body to prepare and release eggs from its ovarian reserve. This happens during puberty. It ends when your ovarian reserve is gone, which may be the start of early menopause. Your body can still produce hormones without releasing eggs, so it is important to remember that even if you still have menstrual periods, it does NOT necessarily mean you are fertile.

As a cancer survivor, it is common to undergo a yearly checkup with your cancer team. During this checkup, you may be able to have an ultrasound to help examine your ovarian reserve, or blood tests that can help evaluate how your ovaries were affected by your cancer therapy. Your doctor can monitor these tests over time to help determine if your fertility was affected and if and when freezing cells might be a good option for you.


If you DO choose to freeze reproductive cells, there are two preservation options available.
If you have started puberty, then your first step will be to meet with a fertility preservation specialist called a Reproductive Endocrinologist to discuss the possibility of freezing some of your remaining eggs.
If you have not started puberty or do not wish to undergo egg or embryo freezing, your doctor will talk to you about an experimental procedure in which one of your ovaries can be removed and frozen. This procedure is usually performed in younger girls who may not tolerate the procedure to save eggs, or if your doctors feel your fertility window is closing at a fast rate.

Remember, there are many ways to have a family. If you chose to undergo freezing eggs, embryos, or an ovary, or if your testing does show that you are infertile, you still have options to be a parent if you want. Your fertility team can help you explore in-vitro fertilization, surrogacy, adoption, and egg donation. Fertility Preservation procedure typically have out of pocket cost. However, resources may be available to help with a portion of these expenses. Talk with your Fertility Preservation Team for more information and don’t be afraid to ask them any questions you may have.