Fertility and cancer: choosing the right fertility treatment for you

For women who are newly diagnosed with cancer and wish to become pregnant after cancer treatment, there are various fertility preservation options that should be considered. Different options have different success rates, and it is never 100%. However, fertility preservation options increase the likelihood of successfully becoming pregnant compared to women who undergo systemic cancer treatment without fertility preservation. It is important to speak to an experienced fertility specialist for the right information.

We encourage you to familiarise yourself with the facts of various procedures and speak with your oncologist and care team who can support you in making an informed decision.

Suitable for:

• Women who already have children and do not necessarily want more
• Women who must commence cancer treatment immediately
• Those who do not have access to fertility treatments
• Those who have sufficient ovarian reserve

Likelihood of pregnancy

• The success of pregnancy will depend on a variety of factors including hormone levels, age and the condition of your ovaries after cancer treatment.

Suitability

• Women with enough time available to complete a full cycle of the procedure before they begin cancer treatment.
• Married females with a male partner (as per Singapore legislation) — for fertilisation to occur under embryo freezing, both sperm and eggs are required.

Likelihood of pregnancy

• An approximate 30% chance for women who have undergone cancer treatment.
• Chances increase in women under 35 years old.
• Women 35 years and older have a reduced rate of success.

Side effects of embryo freezing

• Mood changes
• Hot flushes
• Headaches
• Skin irritations
• Possibilities of infections or bleeding
• Pelvic structures are subject to damage—harmful and discouraged for women with pelvic cancer.

Cancer treatment delay period

14 days.

Treatment effect on the return of the cancer

No data to suggest this will affect the cancer’s return.

For more information on embryo cryopreservation, click here.

Suitability

Women who are not married, do not choose embryo freezing because of their beliefs or have time to go through a cycle of this procedure before starting cancer treatment.

Likelihood of pregnancy

• Females under 35 have a 40% chance when storing 10 eggs. Chances increase through ample storage of eggs.
• Women 35 years and older have a reduced chance.

Side effects of egg freezing

• Mood changes
• Hot flushes
• Headaches
• Skin irritations
• Possibilities of infections or bleeding
• Pelvic structures are subject to damage—harmful and discouraged for women with pelvic cancer.

Cancer treatment delay period

14 days.

Treatment effect on the return of the cancer

No current research indicates the cancer returning.

For more information on oocyte cryopreservation, click here.

Suitability

• Females without time to undergo embryo or egg freezing.
• Women seeking to conceive naturally post-cancer treatment.
• Girls who’ve not reached puberty.

Likelihood of pregnancy

• This is a newer and experimental fertility procedure with only 30% worldwide rate of a live birth.

Side effects of ovarian tissue freezing

This procedure requires surgery, with increased chances of:

• Bladder or bowel damage
• Infection or bleeding
• Cancer cells returned into the body through frozen ovarian tissue—harmful and discouraged for women with leukaemia or other blood cancers.

Cancer treatment delay period

The procedure will usually take a few days. Your cancer treatment practitioner can provide finer details.

Treatment effect on the return of the cancer

There is a potential for cancer cells to be returned into the body through frozen ovarian tissue for women with certain types of cancer. Research has found that the risk is highest for women with leukaemia; moderate for women with breast cancer, gynaecological cancers, and sarcomas of the bone and connective tissue; and low for women with Hodgkin’s and Non-Hodgkin’s lymphoma.¹ Your doctor will discuss any risks of this treatment for you and your cancer.

For more information on ovarian tissue preservation, click here.

Suitability

• Females who have reached puberty.

Likelihood of pregnancy

Insufficient information is available to determine the likelihood of pregnancy through this treatment.

Side effects of ovarian suppression

• Sleep difficulties
• Vaginal dryness
• Hot flushes
• Mood changes
• As ovarian suppression causes the ovaries to stop making oestrogen, this can lead to bone health issues and the development of osteoporosis. You may receive bone density scans to monitor this.
• Musculoskeletal issues such as joint pain or muscle pain may also be more common after suppression of oestrogen

Cancer treatment delay period

Ovarian suppression should start one week before beginning systemic chemotherapy treatment.

Treatment effect on the return of the cancer

Ovarian suppression are used as a treatment to further reduce the risk of cancer recurrence in breast cancer, especially for younger women.²