Pregnancy & Children After Cancer

Source: FertileHope

Many survivors have questions about their ability to achieve pregnancy after cancer and the safety of pregnancy after cancer.  The following information contains general advice that can help you make informed decisions about parenthood after cancer.  For more information about your individual situation, please consult your medical team.

Timeframe for Getting Pregnant

Most oncologists recommend waiting 2 to 5 years after cancer treatments finish before trying to achieve pregnancy.  The majority of cancers recur during this time, so they want to make sure that you are healthy before allowing you to try to get pregnant. However, everyone’s medical situations are different—some survivors have to wait longer and others are approved for pregnancy much earlier.

For women, it is usually recommended that you wait a minimum of 6 months after treatment. This is because your eggs may be genetically damaged from their exposure to chemotherapy and radiation while they were in the process of maturing. The time required for those eggs to leave your body is approximately 6 months.

For men, it is usually recommended to wait a minimum of 2 years after treatment.  Sperm exposed to chemotherapy and/or radiation may suffer genetic damage and this damage is believed to repair itself within 2 years.

Many survivors are confused by the two conflicting answers they get when looking into how long to wait.  This highlights the need for your cancer and reproductive doctors to work together to best determine what timeframe is safe for you from both perspective.

 

Pregnancy & Recurrence

Current available research on this subject is limited, but findings to date suggest that pregnancy after cancer does not cause recurrence, even after breast cancer.

 

Pregnancy & Menopause

It is possible to carry a pregnancy even if you are in menopause.  You will not be able to get pregnant naturally while in menopause, but you may be able to use previously frozen eggs, embryos, or ovarian tissue. You can also use donor eggs or embryos. Achieving pregnancy while in menopause may require hormone treatments to prepare the uterus.  However, as long as your reproductive system is otherwise healthy, you should be able to carry a pregnancy.

 

Miscarriage Risks

An increased risk of miscarriage after cancer is only a concern for a small percent of patients who had radiation to their pelvic area or some fertility sparing gynecologic surgeries.

Miscarriage, preterm delivery, and low birth weight infants are more common in women who received radiation to their uterus. A specialist can evaluate any damage to your uterus and help you determine whether it is safe for you to try to achieve pregnancy.

If you had certain types of fertility sparing gynecologic surgeries, you may also be at greater risk for complications.  For example, if you had a radical trachelectomy, you will need to be closely monitored during pregnancy and you may need to have a cesarean-section in order to give birth.  In addition, if all or part of your cervix was removed, you may be at an increased risk for miscarriage or early delivery.  Discuss these risks with your oncologist and consider seeing a high-risk obstetrician or maternal-fetal medicine specialist before trying to get pregnant.

Current research does not suggest a higher rate of miscarriage after exposure to chemotherapy or radiation to other parts of the body.

 

Pregnancy Health Risks

As you may know, there are a number of long-term health risks associated with chemotherapy and radiation treatments.  Some of these risks, such as damage to your heart or lungs, may complicate your ability to carry a pregnancy or put your health at risk while you are pregnant.  It is important to ask your oncologist about the long-term side effects associated with your cancer treatments and if they may be exacerbated by getting pregnant.  For example, it is recommended that some survivors undergo an echocardiogram to make sure their heart is healthy. If your doctor feels that you are at risk for pregnancy complications, you may need to work with a high-risk obstetrician or look into alternative options like surrogacy or adoption.

 

Birth Defect Risks

The rate of birth defects in children born to cancer survivors (who have been exposed to chemotherapy and radiation) is the same as the general public, 2% to 3%.  There has not been a lot of research done on the subject, but what has been done is very reassuring.

 

Risk of Your Children Getting Cancer

Most cancer survivors want to know if their children are more likely to get cancer because they had it.  In most cases, having a cancer diagnosis itself does not appear to increase your chances of having a child who will develop cancer. Research to date shows that your child’s risk of developing cancer appears to be the same as that of the general public, unless you have a genetically linked cancer.  Only a very small percent of cancers are known to be hereditary.  You may want to ask your doctor or meet with a genetic counselor to better understand your risks for passing cancer on to your offspring.

 

If you do have a genetic cancer and the gene that causes it is known, you may be able to use a test called preimplantation genetic diagnosis (PGD) in conjunction with in vitro fertilization (IVF).  PGD can screen your embryos for that gene to avoid passing it on.  More information can be found at Genetic and Inheritable Cancers.