Becoming a mother after cancer

In recent years, cancer treatments have made considerable progress, however, they have frequent side effects on the fertility of the women concerned. There are ways to overcome these side effects ... The point.

Effects of treatments on fertility

Cancer treatments have made considerable progress in recent years and thus improved the prognosis of many of them. However, they have frequent side effects on the fertility of the women concerned. Radiotherapy in the pelvic area causes definitive sterility if the ovaries are in the irradiation field. Chemotherapy, on the other hand, can disrupt the menstrual cycle depending on the medication used and the age of the woman, but it is still possible to regain normal fertility in more than half of the cases. After 40 years, however, things get complicated, an amenorrhea following chemotherapy increases the risk of early menopause.

Ways to prevent and preserve the possibility of a future pregnancy

Several techniques help to preserve fertility after cancer. The most effective method is in vitro fertilization after embryo freezing, but it only applies to women who are in a couple who have a desire to have a child with their spouse when they learn about their cancer. Another more common technique is the freezing of oocytes. It is offered to women who are old enough to have children. The principle is simple: after ovarian stimulation, the oocytes of a woman are collected and frozen for future in vitro fertilization. Regarding breast cancer, "the preservation is done once the young woman has been operated on her cancer because we do not know what effects could ovarian stimulation have on the growth of the tumor," says Dr. Loïc Baker, gynecologist surgeon at the Jeanne de Flandre Hospital of Lille University Hospital. Then, if necessary, the patient undergoes chemotherapy. The last method, called ovarian cryopreservation, is for girls who are not yet pubescent. It involves taking an ovary or only a part and freezing it in the perspective of a possible transplant when the woman wishes to have children.

The risk of infertility, not sufficiently taken into account

"All these fertility preservation methods should be systematically discussed and offered to young women who are being treated for cancer," says Dr. Boulanger. At the CHU Lille, a specific consultation has been set up, it even fits into the therapeutic scheme of cancer. However, this is far from being the case everywhere in France, as highlighted by this recent survey of the National Cancer Institute (INCA) Only 2% of women surveyed have been treated to preserve their eggs and the use of these methods before initiation of treatment was proposed to only one-third of those surveyed. These results can be explained in part by the lack of information from patients and physicians.

When to start a pregnancy after cancer?

Professionals have long recommended waiting 5 years after the end of cancer treatments before starting a new pregnancy, but now this dogma is somewhat outdated. "There is no one-to-one answer, it depends on the age of the woman, the aggressiveness of her tumor," observes Dr. Boulanger. What we are trying to avoid is that the woman will reoffend during a possible pregnancy. Several studies have shown that pregnancy does not increase the risk of recurrence. Nevertheless, the risk of relapse exists and is more important than in a woman who has never had cancer.