Because chemotherapy can affect a woman’s ability to have children, women of childbearing age faced decisions about whether to take steps to preserve their fertility before undergoing treatment. Some women did not consider fertility to be their priority in the circumstances and were comfortable accepting whatever happened. For others, particularly young women who hoped to have children one day, preserving their fertility was a major concern.
There are a number of ways to preserve fertility during breast cancer treatment. Doctors are looking into preserving fertility by: using treatment to produce embryos or eggs for freezing, reducing the impact of chemotherapy on fertility and trying to preserve ovarian tissue for use in the future. Several women took steps to preserve their fertility. The steps they used, included having Lupron injections and/or freezing their eggs prior to undergoing chemotherapy. Lupron (leuprolide acetate) is used to protect the ovaries from the impact of chemotherapy although its effectiveness is still unclear. It also produces side effects similar to menopause because it decreases estrogen levels.
A number of other women considered freezing their eggs in order to improve their chances of one day having children. Because this has to happen before the start of chemotherapy, the decision often had to be made very quickly in order not to delay treatment. Freezing eggs is an expensive procedure. At the time of these interviews, the treatment or part of the treatment is only covered by some provinces such as Quebec and Ontario. There are also parts of the country where egg freezing is not available so women living in those areas have to travel in order to have the procedure.
For a variety of reasons, several women decided not to freeze their eggs.
While preserving their fertility was an important concern for many women, it was not an issue routinely raised by their cancer teams. While some women did learn about the issue from their oncologist, others only found out about it because it was mentioned by friends or by their family doctor. Melissa thinks that her cancer team did not outline the fertility issue clearly, fortunately her family doctor called her personally to inform her about the risk.