According to 2006 statistics, about 120,00 American women under the age of 50 develop cancer every year, and data show that treatment for cancer – and chemotherapy in particular, which can put women into premature menopause – often affect young women’s chances of having children after having cancer. Radiation can also be problematic to future fertility.
But it's been unclear to both doctors and women with cancer just how much treatment reduces a woman's odds of going on to become a mother, or have more children. So researchers at the University of California at San Francisco (UCSF) wanted to sort out the impact of chemotherapy in particular on over 1,000 women with five different kinds of non-gynecologic cancer – leukemia, Hodgkin disease, non-Hodgkin lymphoma, breast cancer, or gastrointestinal cancer. What did the researchers find? First, that it’s likely the effects of chemotherapy on a woman’s ability to conceive have been underestimated.
To date, physicians have taken it as an encouraging sign of fertility if a woman starts menstruating again after cancer treatment, but the new research at UCSF indicates that even if your period re-starts, you may still be dealing with infertility and early menopause. Age is a factor, too; the older a woman is at the time of her cancer diagnosis, the more likely she is to struggle with subfertility or infertility after treatment. “I think what we have conveyed [in this research] is that a significant long-term implication of cancer treatment -- regardless of menstrual function -- is the compromise to build a family and develop the kind of legacy with children that many of us take for granted,” says study author Mitchell Rosen, M.D., director of UCSF Fertility Preservation Program and Reproductive Laboratories. “Patients need to be particularly pro-active with their medical team so that they are referred to a fertility specialist -- ideally one who has experience working with women who have or have had cancer -- and so they understand their potential risk of reproductive compromise and have the option to play a more active role regarding their post-treatment family planning.” That, says Dr. Rosen, means bringing up the topic with your oncologists and asking for a referral to a fertility specialist so your care can be coordinated between your care providers. Not sure where to look? Online cancer forums can yield good recommendations for specialists, says Dr. Rosen.
Have you had cancer or do you know a younger woman who has? How did you or she navigate these very difficult decisions related to having children?