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Infertility and Chemotherapy: A Critical Concern for Younger Women Facing Breast Cancer 

By Jeannette Vagnozzi

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During my first oncology consultation, my doctor was explaining the staging of my breast cancer and the best course of treatment when, seemingly out of the blue, she asked if I still wanted to have children.  The doctor had just mentioned a bilateral mastectomy and aggressive chemotherapy, two vicious treatments, and suddenly she was asking about my plans for future motherhood.  I was puzzled by her question, which struck me as an odd interjection.  Although I was in my late 30’s, I still believed there was time to conceive a child; my mother was 42 when I was conceived. I wasn’t prepared to make this grand decision in the midst of addressing cancer.

Read a medical oncologist's advice for young women with breast cancer.

Of all the times I spent as a little girl dreaming of becoming a mother, never once did I imagine that I would have no breasts to nurse my child.  Nor did I think my ability to conceive would be challenged.  Never once did I think I would have to make the choice between saving my own life or protecting my ability to bring a life into this world.  Unfortunately, many young women facing a breast cancer diagnosis are also faced with the stark reality that chemotherapy may leave them infertile. 

My oncologist explained the odds were 50/50 that chemotherapy may induce menopause and so discussed the option of harvesting eggs for the future. Faced with my own mortality and the overwhelmingly urgent desire to rid my body of cancer, I couldn’t imagine delaying treatment for any reason. Harvesting eggs would have taken three to six weeks. Doctors typically recommend the time between surgery and the start of chemotherapy as there is usually a six-week delay between the two.

In my case, however, I was scheduled for chemotherapy before surgery. The usual window of opportunity did not exist for me.  The harvesting process generally begins with taking a prescribed drug to stimulate the ovary, followed by an outpatient procedure a few weeks later to harvest mature eggs. As a single woman, I felt that this could be an unnecessary medical procedure in a long line of necessary procedures.  I crossed my fingers, hoped for the best, and opted to begin chemotherapy as soon as possible.

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