Women’s options before cancer treatment
Here we discuss ways a woman can preserve her fertility before starting cancer treatment. It’s ideal to discuss the options with your cancer or fertility specialist at this time. For more on this, see Making decisions.
Ask your cancer specialist how long you have to consider your options. In many cases, you can wait a week or two before starting treatment. Be sure to understand the risks of each fertility option and keep in mind that no method works all of the time.
If you didn’t have an opportunity to discuss your options before cancer treatment, you can still consider your fertility later, but there may not be as many choices available. See Women’s options after cancer treatment.
Learn more about:
Options for preserving fertility in women
Learn more about:
- Wait and see
- Egg or embryo freezing (cryopreservation)
- Ovarian tissue freezing (cryopreservation)
- Ovarian transposition (oophoropexy)
- Trachelectomy
- GnRH analogue treatment (ovarian suppression)
Wait and see
| What is this? | When no method is used to preserve fertility. |
| When is it used? | When a woman decides to leave her future fertility to chance. |
| How does it work? | Requires no action. |
| Other considerations | Not known. |
| Pregnancy rate | Depending on age and cancer treatment. |
Egg or embryo freezing (cryopreservation)
| What is this? | The process of collecting, developing and freezing eggs or embryos as part of an in-vitro fertilisation (IVF) cycle. |
| When is it used? |
When you want to store eggs or embryos for the future. They can be stored for many years. In some states of Australia, you will need to apply for an extension after eggs have been frozen for 20 years and embryos for 10 years. If you have frozen eggs, embryos or ovarian tissue, check the time limits with the fertility clinic, pay any annual fees and keep your contact details up to date. Once you are ready to have a child, the frozen sample is sent to your fertility specialist. |
| How does it work? |
Egg and embryo freezing is part of IVF – the most common and successful method for preserving a woman’s fertility. See a diagram of the IVF process. The cycle starts with your period, and you have an egg collection mid-cycle, usually around day 14. This is a minor procedure in an operating theatre. |
| Other considerations | Your cancer specialists will plan cancer treatment to give you time to have IVF. |
| Pregnancy rate | Depending on age, the success rate of the fertility clinic, and the stage the embryos are stored at, there may be a 25–40% chance per cycle of an embryo developing into a pregnancy. Many thousands of babies have been born from mature eggs that have been frozen, and millions of babies have been born from frozen embryos. A modern technique called vitrification means that freezing eggs is equally as effective as freezing embryos. Some women prefer to freeze eggs, particularly as they may change partners later. |
Ovarian tissue freezing (cryopreservation)
| What is this? | The process of removing, slicing and freezing tiny pieces of tissue from an ovary for later use. |
| When is it used? | If there isn’t a lot of time before treatment, if hormone stimulation is unsafe, or if the patient hasn’t gone through puberty. |
| How does it work? |
Tissue is removed during keyhole surgery (laparoscopy). Under general anaesthetic, a small cut is made near the bellybutton to access the pelvic area. If you are having pelvic or abdominal surgery as part of your cancer treatment, the tissue can be removed at this time. Tissue is frozen until needed. When you are ready to conceive, the ovarian tissue slices are transplanted (grafted) back into your body. Tissue can start to produce hormones, and eggs can develop. |
| Other considerations |
Considered experimental. There is a risk that storing tissue before treatment begins means it will contain cancer cells. This risk is higher for people with leukaemia. It’s important to discuss this risk with your doctor. |
| Pregnancy rate |
To date, approximately 100 births worldwide from ovarian tissue removed after puberty. |
Ovarian transposition (oophoropexy)
| What is this? | A type of fertility-sparing surgery. It involves moving one or both ovaries to preserve their function. |
| When is it used? | When the ovaries are in the path of radiation therapy. |
| How does it work? |
One or both of the ovaries are moved higher in the abdomen – sometimes as high as the lowest ribs – to lower the amount of radiation your ovaries receive. |
| Other considerations | Not known. May cut off blood supply to the ovaries, causing loss of function. |
| Pregnancy rate |
Depends on your age, the amount of radiation that reaches the ovaries, and if you start menstruating again. |
Trachelectomy
| What is this? | A type of fertility-sparing surgery. It involves removing the cervix, upper part of the vagina, and lymph nodes in the pelvis but preserving reproductive organs. |
| When is it used? | For small, localised tumours in the cervix. |
| How does it work? |
The cervix is partially or completely removed, but the uterus is left in place and is stitched partially closed. This opening is used for menstruation and for sperm to enter. |
| Other considerations | Mid-trimester miscarriage and premature delivery are more common. Women may be advised to have a stitch placed in what remains of the cervix to reduce miscarriage. |
| Pregnancy rate |
It is possible to become pregnant after a trachelectomy. |
GnRH analogue treatment (ovarian suppression)
| What is this? | Gonadotropin-releasing hormone (GnRH) is a long-acting hormone used to cause temporary menopause. Reducing activity in the ovaries may protect eggs from being damaged. |
| When is it used? | During chemotherapy or pelvic radiation therapy. |
| How does it work? |
Hormones are given by injection 7–10 days before cancer treatment starts or within the first week of treatment. Injections continue every 1–3 months until cancer treatment has finished. |
| Other considerations | May be recommended as a backup to other fertility options, such as egg or embryo freezing, or as the only form of fertility protection. |
| Pregnancy rate | Studies suggest this treatment may help women under 35.
|
How in-vitro fertilisation (IVF) works
Click on the icon below to download a PDF booklet on Fertility and Cancer.
Instructions for downloading and reading EPUB files
Apple devices
The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:
- email EPUB files to yourself and transfer the attachment to iBooks.
- copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
- open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.
Need more help? Visit: http://support.apple.com/kb/HT4059
Kobo
To download an EPUB file to your Kobo from a Windows computer:
- download and save the EPUB directly onto your desktop.
- connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
- select “Open folder to view files” to view the contents of your Kobo.
- navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.
To download an EPUB to your Kobo from a Mac:
- download and save the EPUB directly onto your desktop.
- connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
- open your “Finder” application.
- select “Kobo eReader” from the listed devices to view the contents of your Kobo.
- navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.
Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3
Sony Reader
To download an EPUB file on your Sony Reader™:
- ensure you have already installed the Reader™ Library for PC/Mac software
- select the eBook you want from our website and click the link to download it.
- connect the Reader™ to your computer.
- open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.
Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/
Amazon Kindle 2nd Generation devices
EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:
- download the PDF directly onto your computer.
- connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
- open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
- safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.
Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630
Android and PC
You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.
This information was last reviewed in May 2018
Support services
Coping with cancer?
Speak to a health professional or to someone who has been there, or find a support group or forum
Need legal and financial assistance?
Pro bono services, financial and legal assistance, and no interest loans
Looking for transport, accommodation or home help?
Practical advice and support during and after treatment
Cancer information
What is cancer?
How cancer starts and spreads
Sexuality, intimacy and cancer
This is for people with cancer and their partners. It aims to help you understand and deal with the ways cancer and its treatment may affect your sexuality.
Dealing with the diagnosis
Common reactions to a cancer diagnosis and how to find hope
