You’re a young woman, just diagnosed with breast cancer. Will treatment affect your fertility? Will you ever be able to have children? Find out what breast cancer and its treatment may mean to your future as a mom.

Q. I’m 32 years old, and have just found out I have breast cancer. I’m engaged to be married, and we’d planned on having kids right away. Am I still going to be able to get pregnant? Help!

A. OK, your first move is to stay calm and focused. Cancer treatment may not impair your ability to become pregnant, once you’ve finished treatment. If your cancer is very early, and will be treated only with a lumpectomy and radiation followed by tamoxifen, then there’s every chance you can still have children “the normal way” – someday. (Tamoxifen can damage a developing fetus, so you’d need to postpone pregnancy till after you’d finished taking it.)

On the other hand, if you’re going to need chemotherapy, there’s a possibility that you’ll have to resort to non-standard methods of becoming pregnant: e.g., in-vitro fertilization. Unfortunately, one of the most common chemo drugs used to treat breast cancer, Cytoxan, is particularly toxic to the ovaries and your stored eggs. So having chemo can make you infertile.

Ask to be assigned to an oncologist ASAP, and let him/her know you want to become pregnant after treatment. It’s important that you make a possible plan quickly, even before surgery; if your pathology report post-surgery reveals that you’ll need chemo, the clock will be ticking for you to harvest eggs for future use prior to chemo – a process that can take up to 6 weeks. 

Q. Assuming I’ll need chemo, what do I need to do right now?

A. Chemo can affect your fertility temporarily, or permanently; it all depends on your age and the type of chemo. The younger you are, the more eggs you still have and the more viable they are. You’ll stop having your period during chemo, but afterwards, if the chemo wasn’t overly toxic to your ovaries, you should resume ovulating, and should still have a good supply of healthy eggs.

On the other hand, certain types of chemo can destroy all of your eggs. And for women who are older, even less-toxic chemo can destroy enough eggs to stop periods permanently.

To prepare for any possibility, it’s good to look into harvesting healthy eggs prior to chemo, so they can be stored for future use.

Q. How do I begin this process?

A. You’ll want to be referred to a reproductive endocrinologist, who can explore various options with you.

The easiest course, though not the most successful, is to harvest and freeze unfertilized eggs. Unfortunately, unfertilized eggs don’t keep well; freezing tends to damage them, so your chance of having a healthy baby using a stored unfertilized egg is slim, at this point.

Women see much more success with in-vitro fertilization, where eggs are harvested and immediately combined with sperm to fertilize them. They’re then frozen, and will be ready to implant into your uterus once you’re completely through treatment. Currently, up to 32% of women undergoing IVF will have a healthy baby.