Fertility is known as the ability to get pregnant. If you’re a young woman diagnosed with breast cancer, treating the cancer might be the only thing on your mind — you may not necessarily be thinking about starting a family in those moments. But whether you’ve always known you’d like to start a family or you’re unsure, it’s important to know that some breast cancer treatments can make it harder to get pregnant.
Breast cancer treatments can impact fertility in different ways. For example:
Some fertility and pregnancy situations are unique and require specific kinds of care:
Different breast cancer treatments can affect fertility in different ways. Here, we’ll talk about the ways that chemotherapy and hormonal therapy, two common treatments, can impact fertility.
Chemotherapy can affect fertility by damaging the DNA in immature egg cells in the ovaries. This means having fewer eggs than you did before chemotherapy.
Chemotherapy can also cause the ovaries to stop releasing eggs and making estrogen. This can trigger premature menopause, sometimes called medical menopause, in some women. After menopause, you can no longer get pregnant. But the younger you are, the lower the risk of chemotherapy-related menopause, especially if you’re under age 40.
Chemotherapy’s long-term effects on fertility depend on your dose and your age. Certain types of chemotherapy pose higher risks than others:
Some doctors advise not getting pregnant for at least 6 months after chemotherapy is finished. Others suggest waiting at least 2 years before trying to have a baby. The longer time frame increases the chances you have fully recovered from chemotherapy and also helps you and your care team make sure the cancer has not returned.
In a study published in 2019, researchers tested the effect of an ovarian suppression medicine called goserelin on fertility of women being treated for hormone receptor-negative breast cancer. The study showed that when women took the medicine with chemotherapy, their ovaries were protected from the effects of chemotherapy and they were more likely to have a baby after treatment. Research on this treatment combination, and its effects on fertility, is ongoing.
If you think you want to have children in the future, let your doctor know as early as possible before treatment starts. Ask to be referred to a fertility specialist to talk about options, such as freezing eggs or embryos for later use.
Hormonal therapy can have an impact on your menstrual cycle and your fertility:
It’s also important to know that hormonal therapy can harm an unborn baby, and cannot be taken while pregnant. That’s why your doctor may suggest using a long-acting non-hormonal reversible contraceptive (birth control) such as a copper IUD or barrier birth control such as a diaphragm or condoms while taking hormonal therapy.
Three types of hormonal therapy are approved for premenopausal women:
To learn more about timing hormonal therapy and starting a family, visit Getting pregnant after early breast cancer. You can also watch one woman’s video story about pausing tamoxifen to have a baby.
Ovarian suppression can be a side effect of centrally acting hormone blockers, such as goserelin and leuprolide, taken during chemotherapy. It can be temporary or permanent. This often depends on your age and how close you are to natural menopause. The younger you are, the more likely you are to become pregnant after treatment ends.
Ovarian shutdown can also be done on purpose for two different reasons:
You may be able to get pregnant and have healthy babies after breast cancer treatment. If being able to have children is important to you, let your doctor know this before you start treatment, if possible. You may want to ask to be referred to a fertility specialist who has worked with women being treated for breast cancer. If you did not have a conversation about fertility and you’ve already started treatment, don’t worry. There are still options available. Talking with a fertility specialist can help.
Here are some questions to ask your oncologist and your fertility specialist:
Learn more about protecting your fertility during treatment.
Hear how Meghan did
Meghan, a physical therapist and lacrosse coach, became a mom after an early-stage and then a stage IV breast cancer diagnosis. She shares her story about affording and undergoing fertility preservation, having a baby via a gestational carrier, and coping with her diagnosis. Learn about her experiences in this Can and Did podcast episode.
If you think you want to get pregnant after having breast cancer treatment, know that having a baby doesn’t make cancer more likely to recur or affect your long-term survival. Visit Getting pregnant after early breast cancer to learn more.
There are also other options for women who want to have a family after breast cancer treatment. Some women choose to use an egg donor or surrogate to help them have a baby. Others prefer to adopt.
Here are some organizations that provide financial assistance for fertility procedures, including surrogacy:
For more detailed information about surrogate pregnancy, visit the American Pregnancy Association and the National Infertility Association.
To learn more about adopting a child, visit the National Council for Adoption.
What are some ways to preserve fertility if you’ve been diagnosed with breast cancer?
Ways to preserve fertility include harvesting or freezing eggs or embryos, and ovarian suppression. Visit Protecting your fertility during treatment to learn more.
Can pregnancy cause breast cancer to recur?
No. Studies show pregnancy after breast cancer treatment does not raise your risk of getting cancer again.
Does chemotherapy pose a risk of birth defects if I get pregnant after treatment is over?
Studies show there is a risk of birth defects if you get pregnant during or after receiving some types of chemotherapy, hormone therapy, and radiation therapy. Some doctors suggest waiting 6 months to decrease the risk of birth defects; others prefer you wait 2 to 5 years to be sure the medicine has left your body.
How does breast cancer affect the reproductive system?
Having breast cancer doesn’t directly affect your reproductive system. The treatments can, however, affect your ability to get pregnant and have a baby. For example, chemotherapy can decrease how many eggs your body makes, which affects your ability to get pregnant. Hormonal therapies can also impact your fertility in different ways. There are options to help women preserve their fertility. It’s best to talk to your healthcare team about that before starting treatment.
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Living Beyond Breast Cancer is a national nonprofit organization that seeks to create a world that understands there is more than one way to have breast cancer. To fulfill its mission of providing trusted information and a community of support to those impacted by the disease, Living Beyond Breast Cancer offers on-demand emotional, practical, and evidence-based content. For over 30 years, the organization has remained committed to creating a culture of acceptance — where sharing the diversity of the lived experience of breast cancer fosters self-advocacy and hope. For more information, learn more about our programs and services.
