When diagnosed with breast cancer, you have to learn a lot and make hard decisions in a very short period. Surgery, chemotherapy, radiation therapy, or hormone therapy—all of these may have you wondering not just how you get through, but what the long-term consequences are. In fact, one of the most important things many women face after cancer in their reproductive years is how it affects their fertility and whether they can get back to normal through a future family.
Whether wanting future children or just keeping options open, egg freezing before cancer treatment is a conversation worth having. During Breast Cancer Awareness Month, we also want to make space for this part of fertility care. You deserve the chance to understand your fertility preservation options without feeling that you need to have every answer right away.
Why Consider Fertility Preservation Before Breast Cancer Treatment?
Though surgery rarely affects fertility, other breast cancer treatments can lower chances. Some chemotherapy medications damage ovarian follicles, while radiation therapy not only affects the eggs, but also can fibrose (“scar”) the uterus. As importantly, many oncologists (cancer doctors) want you to wait at least two years and sometimes even five before having a pregnancy after breast cancer diagnosis and treatment.
Much of cancer treatment is custom to you, so the effect of therapy on fertility depends on factors such as your age, ovarian reserve, breast cancer diagnosis (including hormonal susceptibilities), treatment type, and treatment dose also play a role.
For some patients, egg freezing can be completed quickly enough to fit between diagnosis and breast cancer treatment when timing allows. However, it is very important to communicate an interest in preserving fertility as early as possible, as there may be windows relative to your menstrual cycle that allow some days to be better than others. Though many team members pitch in to help given how urgent cancer care can be, our fertility specialist, Dr. Preston Parry, will review your reproductive health alongside your oncology plan and explain whether egg freezing, embryo freezing, or another approach may fit your circumstances.
How Long Does Egg Freezing Before Breast Cancer Treatment Take?
The ovarian stimulation portion of egg freezing usually takes about 10 to 14 days. This can allow storing of 10-30 eggs in a month, though the true number depends on your ovarian reserve. Flexible-start protocols mean reproductive endocrinologists can often begin treatment at different points in the menstrual cycle instead of waiting for the next cycle to start.
The egg freezing process generally includes:
- Blood tests and ultrasound to assess ovarian reserve
- Hormone injections while your fertility clinic monitors follicle development
- Egg retrieval once multiple eggs reach maturity
- Freezing and storage of mature, unfertilized eggs for future use
For some patients, fertility treatment may slightly delay breast cancer treatment, so your fertility specialist and oncology teams should look at your treatment schedule together and determine whether there is enough time to complete fertility preservation safely. Though we want to respect freedom for conception, your survival comes first.
Is Ovarian Stimulation an Option With Breast Cancer?
If you have hormone-sensitive breast cancer, it is completely reasonable to have questions about the temporary rise in estrogen that occurs during ovarian stimulation.
For some patients, reproductive endocrinologists use an aromatase inhibitor such as letrozole during stimulation to help limit estrogen exposure around breast cancer cells.
Your doctors will still need to consider your specific breast cancer diagnosis, hormone receptor status, ovarian function, and treatment plan before recommending a fertility approach. There is no single protocol for every patient.
Doctors may also discuss ovarian suppression during chemotherapy treatment for some patients with breast cancer. Medications used to block hormones may be given as monthly injections during chemotherapy for some patients. Ovarian suppression may have a place in breast cancer care, but it does not replace established fertility preservation methods such as egg freezing, embryo freezing, or ovarian tissue cryopreservation.
What Other Fertility Preservation Options Are Available?
Egg freezing is one way to preserve fertility, but it is not the only option. Our fertility specialist, Dr. Preston Parry, may talk with you about several approaches depending on your diagnosis and how soon breast cancer treatment needs to begin.
- Embryo freezing involves retrieving eggs, fertilizing them with sperm from a partner or sperm donor, and freezing the resulting embryos for future use.
- Ovarian tissue cryopreservation involves removing and freezing ovarian tissue that contains eggs.
- Ovarian transposition moves the ovaries away from an area that will receive radiation therapy.
- Ovarian suppression may be used alongside other care for selected patients with breast cancer.
Embryo freezing may suit patients who are comfortable creating embryos now. However, it requires a partner for fertilizing the eggs with sperm. Egg freezing keeps the eggs unfertilized, which means you do not need a partner or sperm donor at the time of treatment, but you need more eggs for a slightly worse embryo relative to fertilizing the eggs fresh. One context beyond having a partner is that if one freezes oocytes, one can’t know their genetic potential, while if you freeze embryos, they can be biopsied (at your request) for important conditions such as BRCA-1 & 2.
Ovarian tissue freezing may be considered when there is not enough time for ovarian stimulation and egg retrieval. Ovarian tissue cryopreservation does not require the same stimulation period, which may make it relevant for selected patients who cannot delay breast cancer treatment.
These fertility preservation options each have different medical considerations. Your oncology and fertility doctors can narrow the discussion to what actually applies to you.
What Happens to Frozen Eggs Later?
If you decide to use your frozen eggs in the future, the embryology laboratory thaws them and fertilizes them with sperm to create embryos. If an embryo develops appropriately, our fertility specialist may later transfer it during an IVF cycle.
Egg freezing, also called oocyte cryopreservation, can preserve reproductive potential for future use, however, it cannot guarantee that you will get pregnant. Success rates depend on several factors, including your age when the eggs are frozen, egg quality, the number of mature eggs stored, and your reproductive health after completing breast cancer treatment. Women under 35 have higher success rates with frozen eggs because egg quality changes with age.
Some people may also fall pregnant naturally if ovarian function returns after treatment before attempting pregnancy. Others may use assisted reproductive technologies. Our fertility specialist can discuss what your stored eggs or embryos may mean for you based on your own circumstances rather than relying on a general statistic.
What Should You Ask Before Breast Cancer Treatment Begins?
You do not need to understand every fertility term before speaking with your doctors. A few questions can make the conversation easier:
- Could my breast cancer treatment affect my ovarian function or future fertility?
- How much time do I have before treatment needs to begin?
- Which fertility preservation options are appropriate for me?
- How will my oncology team and fertility specialist coordinate my care?
- What should I expect for fertility treatment costs, storage, health insurance, and insurance coverage?
The financial side of fertility preservation can also feel like a lot to take in during an already demanding time. Costs vary between fertility clinics, and annual storage fees may apply to frozen eggs or embryos. However, we work with the Livestrong foundation, which can help greatly reduce IVF treatment and medication costs.
When Should You Ask About Egg Freezing Before Breast Cancer Treatment?
If you think you may want children in the future, or you simply do not want to close that door without understanding your options, ask about egg freezing before breast cancer treatment as early as your medical situation permits. You are not committing to fertility treatment by having the conversation. You are giving yourself the information needed to make a decision with your oncology and fertility doctors.
At Positive Steps Fertility, board-certified reproductive endocrinologist and infertility specialist Dr. Preston Parry leads fertility care for patients across Madison, Gulfport, Hattiesburg, Starkville, Shreveport, Slidell, and Monroe. Dr. Parry previously served for six years as Chief of Reproductive Endocrinology and Infertility at the University of Mississippi Medical Center and invented the patented Parryscope®. Positive Steps Fertility reports a 64.2% live birth rate per retrieval for patients under 35, placing the fertility clinic among those with the highest reported live birth rates in the South.
If you would like to understand whether egg freezing before breast cancer treatment is appropriate for you, schedule a consultation with Positive Steps Fertility to talk through your fertility preservation options and treatment timeline.
Frequently Asked Questions About Egg Freezing Before Breast Cancer Treatment
Can I freeze my eggs if I do not have a partner?
Yes. Egg freezing stores mature, unfertilized eggs, so you do not need a partner or sperm donor. If you decide to use those frozen eggs later, sperm will be needed to create embryos.
What if my breast cancer treatment needs to start very soon?
Your doctors can look at the time available before breast cancer treatment and discuss which fertility preservation options remain possible. Ovarian tissue freezing may be considered for selected patients because it does not require the ovarian stimulation period used for egg or embryo freezing. However, many lean away from tissue freezing owing to the cost and access to capable fertility surgeons.
How long can frozen eggs stay in storage?
Fertility clinics can keep properly frozen eggs in storage for many years. Our fertility clinic can explain its storage policies, annual fees, and what happens when you are ready to consider future use.
What if I don’t know whether I want children yet?
You do not need to make that decision before speaking with our fertility specialist. If you are uncertain about future pregnancy, a consultation with Dr. Preston Parry gives you the chance to understand your options before breast cancer treatment begins.
