Oocyte (unfertilized egg) freezing
How can this delay my treatment? Egg freezing takes approximately 2 weeks to complete.
Each month during ovulation, your ovaries usually release one egg. But when you freeze eggs for later use, your doctor will try to collect as many eggs as possible. To do so, you will give yourself hormones that encourage your ovaries to mature more than one egg.
The time from when you begin stimulation medicines until your egg retrieval can take anywhere from 10 to 15 days. In some cases, you can complete a cycle of egg freezing after breast surgery and before any additional therapy begins. If you need chemotherapy before surgery, an egg freezing cycle should be started as soon as possible for a minimal delay in starting chemotherapy.
How much will this cost? The egg freezing process can cost between $10,000 and $15,000, with prices that vary depending on where you get care, what (if anything) your insurance will cover, and additional charges such as appointments, tests, and travel.
Other costs may include yearly storage for the eggs and medicines for stimulation. When you are ready to try to get pregnant you will have to pay for the eggs to be thawed, fertilized, and placed in your uterus which can run about $5,000.
It is possible that the medical fertility preservation procedure may be covered by your insurance. To be sure, contact your insurance provider. If it is not covered by your insurance, you may be eligible for financial assistance through some national programs that help with the cost of fertility preservation for cancer patients.
Can this interact with my hormone receptor-positive breast cancer? There is no evidence that using hormones for the egg freezing process affects hormone receptor-positive breast cancer.
To help prevent breast cancer from coming back, your doctor will likely recommend taking hormonal therapy for 5 to 10 years. If you want to get pregnant during that time, speak with your doctor about safely taking a break from hormonal therapy while you attempt pregnancy. Hormonal therapies can harm a fetus if taken during pregnancy. You should not attempt pregnancy while actively taking hormonal therapy.
Does my age impact this? Yes. Because women are born with all the eggs they will ever have, the older a woman is, the more likely the eggs are to have problems that can lead to an increase in birth defects and miscarriage.
Some fertility centers restrict how old you can be when you attempt pregnancy. Be sure to ask your provider if there is an age limit for the transfer of a fertilized egg at your center.
Do I need a partner or sperm donor? Not now. Eggs can be frozen without being fertilized, so you will not need sperm from a partner or donor until you are ready to attempt pregnancy. Legally, this means that these eggs belong to you and you alone, even if you are in a domestic partnership or marriage.
More about oocyte (unfertilized egg) freezing
The best time to undergo egg freezing is before breast cancer treatment like chemotherapy begins. The process includes getting hormone injections for about 2 weeks. Medicines signal the ovaries to mature multiple eggs at once, instead of the single egg that is usually matured each month. Your fertility doctor may also have you take a medicine like tamoxifen or an aromatase inhibitor during stimulation, to try to decrease the rise in estrogen that occurs because of stimulation medicines.
To remove the eggs from your body, a doctor will insert an ultrasound device into your vagina to find the mature eggs stored in your ovaries. A needle is then guided into the ovary to remove each egg. The eggs are then frozen, without being fertilized, for use after your breast cancer treatment ends and your oncology team has cleared you to attempt pregnancy or you choose to use a surrogate to carry the pregnancy.
When you are ready to attempt pregnancy, the eggs are thawed and fertilized with sperm from either a donor or your partner. If the fertilized egg develops into a healthy embryo, it can be implanted into your uterus at your doctor’s office.
If you have a family history of breast cancer and know you carry a gene mutation related to cancer, it is possible to test the embryo to see if it also carries the mutation. Your fertility specialist will have more information on these tests.
Egg and embryo freezing are considered the standard-of-care approach to preserve fertility. While freezing embryos has a higher pregnancy rate, egg freezing is a good option that does not require you to have a partner or sperm donor.
It can be stressful to make decisions about fertility right after a breast cancer diagnosis. You may want to get started with cancer treatment quickly, or your doctors might recommend neoadjuvant therapy, chemotherapy before surgery. Perhaps you have not thought about having children yet, and cancer is now forcing you to do so.
Talk with your oncologist about timing and any concerns you have — there may be ways to make a schedule that works for you and your treatment plan. Your oncologist can also communicate directly with the fertility doctor to ensure the delay to starting breast cancer treatment is minimal.
