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Fertility preservation options for women with cancer
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.
Option 1
No fertility preservation - cancer treatment begins immediately
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Suitability
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
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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.
Option 2
Embryo freezing (embryo cryopreservation)
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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.
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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.
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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.
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Cancer treatment delay period
14 days.
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Treatment effect on the return of the cancer
No data to suggest this will affect the cancer’s return.
Learn more information on embryo cryopreservation.
Option 3
Egg freezing (oocyte cryopreservation)
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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.
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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.
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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.
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Cancer treatment delay period
14 days.
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Treatment effect on the return of the cancer
No current research indicates the cancer returning.
Learn more about oocyte cryopreservation.
Option 4
Ovarian tissue freezing
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Suitability
Females without time to undergo embryo or egg freezing.
Women seeking to conceive naturally post-cancer treatment.
Girls who’ve not reached puberty.
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Likelihood of pregnancy
This is a newer and experimental fertility procedure with only 30% worldwide rate of a live birth.
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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.
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Cancer treatment delay period
The procedure will usually take a few days. Your cancer treatment practitioner can provide finer details.
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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.
Learn more about ovarian tissue preservation.
Option 5
Ovarian suppression
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Suitability
Females who have reached puberty.
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Likelihood of pregnancy
Insufficient information is available to determine the likelihood of pregnancy through this treatment.
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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
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Cancer treatment delay period
Ovarian suppression should start one week before beginning systemic chemotherapy treatment.
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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
References
Content found on the Icon Cancer Centre Singapore website is for informational purposes only and should not be considered medical advice. It is not a substitute for consultation with a qualified medical practitioner. For personalised medical guidance, please consult with your GP or another qualified healthcare provider.
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