Other fertility decisions to consider

The focus of this website so far has been helping you to make the right fertility preservation decisions for you before starting cancer treatment. This section provides some more information about the other fertility decisions young women may have to make during and after cancer treatment.

• During cancer treatment:

These decisions may include what type of contraceptive option to use.

• After cancer treatment and follow-up:

These decisions may include what type of contraceptive to use, what methods of fertility testing to have and planning for a future family.

Contraception during cancer treatment

Young women are strongly advised not to get pregnant whilst having cancer treatment. This is because cancer treatments can damage an unborn baby. Even if your periods stop during treatment, you can still become pregnant.

If you are sexually active you should use a reliable contraceptive method throughout your cancer treatment.

Picture 2 below shows the different types of contraception you should consider.

If you are having hormone treatments it is recommended that you use non-hormonal methods of contraception. These include condoms, female condoms (Femidoms) and diaphragms. Young women with hormone sensitive cancers are not advised to take the contraceptive pill as the hormones in the pill could stimulate any remaining cancer cells. If you discuss contraception with your cancer care team they may refer you to a family planning clinic or your GP who will be able to help you further.

Here are some questions which may help you talk with your cancer care team or GP about contraception:

The following questions may help you talk with your cancer care team or GP about contraception.

• What contraceptive would be best for me during cancer treatment?
• How long do I need to use this contraceptive for?
• Do I need to use non-hormonal methods of contraception for my cancer type?
• If I am not having a period during my cancer treatment, should I still use contraceptives?
• Will it affect me or my unborn baby if I choose not to use contraception and become pregnant during my cancer treatment?

Family planning decisions after cancer treatment

You may find that making decisions about pregnancy after your cancer diagnosis is difficult. Your decisions about fertility management will be made on what best suits your life. These include having tests to check fertility, choosing a contraceptive method and planning your future family. This is shown in picture 3 below.

It is difficult to predict how your fertility will be affected by cancer treatment. The fertility care team can check your fertility through tests including blood tests to check your hormone levels or an ultrasound scan of your ovaries. You can ask your GP or cancer care team to refer you to a fertility clinic for this support.

Your fertility may return naturally after cancer treatment. Even if your periods have not started again, you may still be producing eggs and could become pregnant. Your GP or cancer care team can advise you on the options and the best type of contraception for you. You may choose not to have any children but if you do want a family it is advised that you wait for two years after completing your cancer treatment before trying for a baby.

Data does not suggest that pregnancy affects the chances of a cancer coming back. Data does not suggest that the health of children born after cancer treatment is affected. You can talk with your cancer care team if you are thinking about getting pregnant.

Not all young women who have cancer treatment will have a fertility problem, in fact most young women who want to have a baby after cancer treatment are able to.

Occasionally a young woman may find herself unable to have children which can be upsetting and difficult to come to terms with. Support and help is offered by your fertility care team. They can offer emotional support and information on other options. These include surrogacy, adoption and fostering. They can also advise on methods of assisted pregnancies such as donor eggs and embryos or using your own saved eggs, embryos and ovarian tissue.

The HEFA website www.hfea.gov.uk has more information about egg or embryo donation and surrogacy.

The organisations listed in our information section include information and support for people interested in fostering and adoption.

Here are some questions which may help you talk with your cancer care team or GP about having a baby after cancer treatment:

• How will I know if I am fertile after cancer treatment?
• How long before I know if I am fertile?
• Are there any tests that I can take to check if I am still fertile after cancer treatment?
• If I became pregnant would the cancer come back?
• If I can still have a baby, how long after treatment should I wait?
• If I become pregnant after cancer treatment, will my child have a higher chance of getting cancer?
• If I didn’t have fertility preservation before cancer treatment, do I still have options?