Ovarian suppression to preserve fertility
How can this delay my treatment? You can start taking ovarian suppression medicine right away, and it should not delay treatment.
How much will this cost? Up to $500 a month, which comes out to $6,000 for a year of treatment. If your doctor recommends ovarian suppression as part of your breast cancer treatment plan, it may be covered by insurance.
Can this interact with my hormone receptor-positive breast cancer? No. By shutting down the function of your ovaries, these medicines stop much of the estrogen and progesterone production in your body. This may make other medicines, like aromatase inhibitors, available to you and lower the risk of cancer returning, but this is still being studied.
Your doctor will likely recommend taking hormonal therapy for 5 to 10 years. If you want to get pregnant in this time, speak with your doctor about safely taking a break from hormonal therapy while you get pregnant and give birth.
Does my age impact this? Yes. Ovarian suppression may protect you from the long-term effects of breast cancer treatments and help your period return after treatment ends. The younger you are, the more likely it is that you will start having periods again. If you are in your mid-30s or older, it is less likely that your periods will return, even with ovarian suppression.
Do I need a partner or sperm donor? No. The goal of ovarian suppression to protect ovarian function so you may attempt pregnancy when active treatment ends. You won’t need a partner or sperm donor until you are ready to become pregnant.
More about ovarian suppression
Some studies have shown that medicines called gonadotropin-releasing hormone agonists (GnRH agonists) may protect the ovaries from the harsh effects of chemotherapy. These medicines shut down or suppress your ovaries. The medicine may cause menopause-like symptoms for as long as you take them.
GnRH agonists are still considered experimental for fertility preservation. Note that this approach does not take the place of standard methods of preserving your fertility, such as freezing eggs and embryos.
The GnRH agonists are:
- goserelin (Zoladex)
- leuprolide (Lupron)
- triptorelin (Trelstar)
Ask your doctors to be specific about what kind of ovarian suppression they recommend. Some doctors use “ovarian suppression” or “ovarian ablation” to mean the same thing. Ovarian ablation can also mean surgery to permanently remove your ovaries.
GnRH agonists are given as an injection once a month, every 3 months, or as an implant that lasts 3 months.
Side effects may include
- bone thinning
- bone pain
- fatigue
- headache
- hot flashes
- insomnia
- joint and muscle aches
- loss of sexual interest
- mood changes
- sweating
- vaginal dryness
- weight gain
