It’s best to talk about ways to preserve or protect your fertility before cancer treatment begins. Fertility is something your treatment team should raise, but you can also bring up the topic yourself.
Learn more about:
- Seeing a fertility specialist
- Asking questions
- Making a decision
- What to consider when making decisions
- The main costs of fertility treatment
Seeing a fertility specialist
Most people find it helpful to receive information and advice about their fertility options. Ask your cancer specialist whether you should see a fertility specialist. You can also get a referral from your general practitioner (GP).
As well as explaining your fertility options, a fertility specialist can help with contraception and hormone management during cancer treatment.
It’s important that you feel comfortable to ask questions about the possible impact of different cancer treatments on your fertility as well as the possible risks of having treatment to preserve your fertility. You may find it helpful to plan some questions in advance and to take notes during the discussion.
The first time I met my surgeon she said, ‘You should go and see a fertility specialist’. It all happened very quickly. The only way to describe the process is that it was overwhelming. However, it’s better not to delay it.Mackenzie
You may feel too overwhelmed by the amount of cancer information you are given at diagnosis to think about fertility. Or you may be asked to make fertility decisions before you’ve given much thought to whether you want to have a child in the future.
Even if you think, “But I don’t want kids anyway” or “My family is complete”, a fertility specialist or counsellor will probably encourage you to consider as many fertility options as possible to keep your choices open for the future. These decisions are personal, and no decision is right or wrong.
Learn more about some things you may want to consider.
For more on this, see Cancer care and your rights.
What to consider when making decisions
After a cancer diagnosis, you may need to make several decisions about your fertility. It can be difficult to decide what to do, particularly if you have several options to consider. You may feel that everything is happening too fast.
Understand the available options
Generally, people make decisions they are comfortable with – and have fewer regrets later – if they gather information and think about the possible outcomes. Ask your health professionals to explain each fertility option, including risks, benefits, side effects, costs and success rates.
Expect to experience doubts
It’s common to feel unsure when making tough decisions. Keeping a journal or blog about your experience may help you come to a decision and reflect on your feelings.
Use a decision aid
A decision aid can help you focus on what matters most to you. Your health professional may be able to recommend a decision aid or give you a booklet setting out the options.
Breast Cancer Network Australia has developed a resource called Fertility-related choices to help younger women with breast cancer make fertility-related decisions.
Talk it over
Discuss the options with people close to you (such as your partner, a friend or family member) or with an infertility counsellor or psychologist. Research shows that couples who make fertility decisions together are happier with the outcome, whatever it is.
Fertility treatments can be expensive and this may be a factor in your decision-making. Costs of specialists and private clinics vary across Australia. You may also be able to have treatment at a fertility unit in a public hospital or a clinic that provides discounted fertility treatment for cancer patients. Ask your fertility clinic about costs.
Depending on the treatment you have, costs may include:
- fertility specialist consultations – ask if they have special fees for people diagnosed with cancer, as sometimes this is the case
- medicines and blood tests
- fees for procedures (e.g. the different steps in the IVF cycle from egg or sperm collection to implantation of embryos after treatment)
- day surgery, operating theatre and anaesthetist fees
- egg, sperm and embryo storage (cryopreservation) – ask your clinic about up-front payments, instalment payments and annual fees.
Costs will depend on whether you are a public or private patient. If you are a private patient, there may be Medicare rebates for some of these costs. Ask your fertility specialist for a written estimate of their fees and any Medicare rebates.
Ask your private health fund (if you belong to one) what costs they will cover and what you’ll have to pay – some funds only pay benefits for services at certain hospitals.
Under Medicare you need a referral to see a specialist. It should list both you and your partner so you can claim the maximum benefit.
Dr Ying Li, Gynaecologist and Fertility Specialist, RPA Fertility Unit, Royal Prince Alfred Hospital, NSW; Dr Antoinette Anazodo, Paediatric and Adolescent Oncologist, Sydney Children’s Hospital and Prince of Wales Hospital, NSW, and Lead Clinician for Youth Cancer NSW/ACT; Paul Baden, Consumer; Dawn Bedwell, 13 11 20 Consultant, Cancer Council Queensland; Maurice Edwards, Special Counsel, Watts McCray Lawyers, NSW; Helena Green, Clinical Sexologist and Counsellor, InSync for Life, WA; Dr Michelle Peate, Program Leader, Psychosocial Health and Wellbeing Research (emPoWeR) Unit, Department of Obstetrics and Gynaecology, Royal Women’s Hospital, The University of Melbourne, VIC; A/Prof Kate Stern, Gynaecologist and Reproductive Endocrinologist and Head, Fertility Preservation Service, Royal Women’s Hospital Melbourne, The University of Melbourne, VIC; Prof Jane Ussher, Chair, Women’s Health Psychology, Translational Health Resea ch Institute (THRI), School of Medicine, Western Sydney University, NSW; Renee Van Den Bosch, Consumer.
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Common reactions to a cancer diagnosis and how to find hope
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