Getting diagnosed with gynaecologic cancer can be emotionally taxing, and adding to that emotional weight is the concern about how treatment might affect the possibility of having children in the future. While necessary treatments like surgery, chemotherapy, or radiation can sometimes impact the ability to conceive, this certainly doesn’t mean that pregnancy is impossible. Fortunately, medical science has advanced greatly, and there are now several options available that can help to preserve or restore fertility, depending on the specific type of cancer and the treatment received. This blog post explores these options in detail, giving clear information if you’re hoping to start a family after your treatment.
How Gynaecologic Cancer Affects Fertility
Gynaecologic cancers, such as ovarian, cervical, or uterine cancer, can sometimes affect fertility depending on their type, stage, and the treatment required. In some cases, the cancer itself may involve reproductive organs like the ovaries or uterus, which play a direct role in conception and pregnancy.
Treatments such as surgery to remove these organs, chemotherapy, or radiation therapy can also impact fertility by affecting egg production, damaging ovarian function, or altering the uterus’s ability to support a pregnancy.
However, not every woman experiences fertility loss, as some treatment approaches are designed to protect reproductive function whenever possible. The exact effect varies for each individual, which is why it’s important to discuss fertility goals with the treating doctor before starting therapy.
Fertility Preservation Options Before Treatment
Planning for fertility preservation before starting cancer treatment can help increase the possibility of having children in the future. The right option depends on factors such as the type of cancer, treatment urgency, and age.
Egg or Embryo Freezing
Eggs can be collected from the ovaries and either frozen directly or fertilised with sperm to create embryos that are stored for later use. This method is suitable for women who have enough time before starting treatment and want to preserve the chance of natural conception or assisted reproductive techniques. Hormonal stimulation is usually required, which may take a couple of weeks, making it one of the most commonly used and effective methods.
Ovarian Tissue Freezing
A small portion of ovarian tissue can be surgically removed and frozen before treatment. This tissue can later be reimplanted to restore fertility or hormone production. Ovarian tissue freezing is often recommended for women who cannot delay treatment for egg collection or are too young for standard egg freezing. While considered experimental in some centres, it has resulted in successful pregnancies in many cases.
Ovarian Transposition
Also known as ovarian relocation, this procedure moves the ovaries out of the area targeted by radiation therapy to reduce the risk of damage. It is usually offered to women who will undergo pelvic radiation and want to preserve ovarian function. Ovarian transposition does not protect eggs from chemotherapy, so it is often combined with other preservation methods to maximise fertility chances.
Hormone-Sparing Treatments
In certain situations, doctors may adjust surgical or medical treatment plans to protect reproductive organs or hormone function. The suitability of this approach depends on the type and stage of cancer as well as overall health, making early consultation with a specialist essential.
Natural Conception
For some women, fertility may remain intact after cancer treatment, making natural conception possible. Factors such as age, ovarian reserve, the health of the uterus, and the type of treatment received play an important role in determining fertility potential. Doctors can perform evaluations, including hormone tests and imaging, to assess reproductive function and help determine whether trying to conceive naturally is a viable option. One of the most commonly used fertility assessments is the AMH test (Anti-Mullerian Hormone test), which helps evaluate ovarian reserve and indicates how many eggs remain, offering valuable insight into future fertility potential. While natural conception is not guaranteed, knowing your reproductive health status can help you plan effectively and set realistic expectations.
Assisted Reproductive Techniques (ART)
When natural conception is challenging, assisted reproductive techniques (ART) offer a way to achieve pregnancy. Procedures like in vitro fertilisation (IVF) can use eggs or embryos that were frozen before treatment or, if necessary, donor eggs. The process involves fertilising eggs in a laboratory and then transferring the resulting embryos to the uterus. ART is often customized to each woman’s medical history and reproductive status after treatment. With careful planning and specialist support, ART can significantly increase the chances of pregnancy even after cancer treatment.
Surrogacy
Surrogacy is an option for women whose uterus cannot safely carry a pregnancy due to surgery, radiation, or other treatment-related effects. In this process, another woman carries the pregnancy using the patient’s eggs or donor eggs. Surrogacy allows women to become genetic mothers even if they cannot carry the pregnancy themselves. It is important to work with both medical and legal experts to ensure the process is safe and meets all requirements. While emotionally complex, surrogacy can provide a meaningful pathway to parenthood for women affected by gynaecologic cancer.
Donor Eggs or Embryos
For women whose ovaries no longer function or whose eggs were affected by treatment, donor eggs or embryos may offer the chance to conceive. Donor eggs can be fertilised and transferred via ART, or embryos created from donor eggs can be carried by the woman herself or a surrogate. Using donor eggs or embryos can significantly improve the likelihood of pregnancy, especially when ovarian function is compromised. Consulting a fertility specialist helps determine the best approach based on individual health, treatment history, and family planning goals.
Consult Today
Having concerns about fertility after gynaecologic cancer is completely valid. With advancements in medical technology and science, there are more options than ever, giving women hope for the future. If you are concerned about fertility after gynaecologic cancer diagnosis, consulting with a gynaecologic oncologist or fertility specialist at one of the top hospitals in India can help you explore the options available for your situation. They can review your health, explain the possibilities, and provide guidance on what might work best for you.
