Skip to content

Female options before cancer treatment

This section has information about ways you can preserve your fertility before starting cancer treatment. It’s ideal to discuss the options with your cancer or fertility specialist or oncofertility specialist at this time. Keep in mind that these methods don’t work all of the time.

If you didn’t have an opportunity to discuss your options before starting cancer treatment, you can still consider your fertility later, but there may not be as many options available.

Learn more about the options below.

What this is

  • when no method is used to try and preserve fertility

When this is used

  • when you don’t have time to consider fertility preservation
  • when you choose to start cancer treatment immediately

How this works

  • requires no action

What to consider

  • more likely to lead to premature ovarian insufficiency

Pregnancy rate

  • depends on age and cancer treatment

What this is

  • the process of collecting, developing and freezing eggs or embryos as part of an in-vitro fertilisation (IVF) cycle

When this is used

  • when you want to store eggs or embryos for use in the future – they can be stored for many years
  • when you are ready to have a child, the frozen egg will be fertilised using IVF or the embryo will be implanted in your uterus

How this works

  • egg and embryo freezing is part of IVF – the most common and successful assisted reproductive technology for preserving female fertility
  • one cycle of IVF can take 2–3 weeks
  • egg collection is done in an operating theatre as a day procedure

What to consider

  • need time to have IVF before cancer treatment – your cancer specialists will advise how quickly treatment should begin
  • ask the fertility clinic about the cost of storing eggs and embryos
  • need sperm from a partner or donor sperm to create an embryo
  • to use a frozen embryo, you will need consent from the sperm donor
  • talk with your fertility specialist about whether to freeze eggs, embryos or a mix of both
  • legal limits on how long eggs and embryos can be stored are different in each state and territory; ask the fertility clinic for details

Pregnancy rate

  • freezing eggs works nearly as well as freezing embryos
  • for every 10 eggs frozen, you can expect to get 1–4 embryos
  • depending on age, the success rate of the fertility clinic and the stage at which the embryos are stored at, there may be a 25–40% chance per cycle of a frozen embryo developing into a pregnancy

What this is

  • the process of removing, slicing, freezing and storing tiny pieces of tissue from an ovary so it can be used later

When this is used

  • if treatment needs to start immediately
  • if taking hormones to encourage egg production is unsafe
  • if there is a high risk of infertility
  • if the person hasn’t gone through puberty
  • can be used in addition to egg freezing

How this works

  • tissue is removed from your ovaries during keyhole surgery (laparoscopy); if you have abdominal surgery as part of cancer treatment, tissue can be
    removed at this time
  • tissue is frozen until it is needed
  • when needed, the tissue is thawed and put back (grafted) into the ovary
  • tissue may produce hormones and eggs may develop

What to consider

  • risk that storing tissue before treatment begins means it will contain cancer cells, and you may not want to put this tissue back into your body; risk is higher for people with leukaemia
  • legal limits on how long ovarian tissue can be stored are different in each state and territory
  • ask your fertility clinic how much you will have to pay for storage

Pregnancy rate

  • there have been a small number of births worldwide from ovarian tissue removed after puberty, and several births from ovarian tissue removed before puberty
  • about a third of people who have tried to use ovarian tissue to become pregnant have been successful

What this is

  • surgery that moves one or both ovaries to prevent damage to the ovaries during radiation therapy

When this is used

  • when one or both ovaries are in the path of radiation therapy
  • limits how much radiation the ovaries receive

How this works

  • one or both ovaries are moved away from the field of radiation and stitched in place
  • put back in place after radiation therapy ends

What to consider

  • procedure may cut off blood supply, causing damage to the ovaries

Pregnancy rate

  • depends on your age, the amount of radiation that reaches the ovaries and if you start menstruating again

What this is

  • trachelectomy removes part or all of the cervix and keeps the uterus, fallopian tubes and ovaries in place
  • unilateral-salpingo oophorectomy removes only 1 ovary

When this is used

  • trachelectomy is for small tumours found only in the cervix
  • unilateral-salpingo oophorectomy is for early-stage cancer found only in 1 ovary

How this works

  • the uterus is stitched tight with a small opening to allow blood to pass out during a period and for sperm to enter

What to consider

  • risk of miscarriage and premature birth; may have a stitch placed in what remains of the cervix to reduce the risk

Pregnancy rate

  • number of births increasing

What this is

  • gonadotropin-releasing hormone (GnRH) analogue is a long-acting hormone that stops the ovaries making oestrogen for a short time
  • may protect eggs from being damaged

When this is used

  • at least 1 week before chemotherapy starts, continuing until chemotherapy finishes

How this works

  • hormone injections given 7–10 days before chemotherapy starts or during the first week of treatment, then every month or every 3 months during chemotherapy

What to consider

  • backup to other fertility preservation options
  • can affect bone density if used for more than 6 months

Pregnancy rate

  • studies show that treatment is suitable for young women with breast cancer but there is no evidence for other types of cancer

How in-vitro fertilisation (IVF) works*

  1. Ovarian stimulation – Hormone injections daily for 10–14 days help stimulate your body to produce more eggs.
  2. Egg collection – Mature egg/s are collected from the follicle using a needle guided by ultrasound.
  3. Egg and sperm combined – The eggs are combined with sperm from a partner or donor, or frozen (cryopreservation) for later use.
  4. Embryo freezing – Fertilised eggs may divide and form embryos. Embryos can also be frozen (cryopreservation) for later use. One full cycle of IVF takes about 2–3 weeks.
  5. Embryo transfer – A syringe and tube is used to implant embryos into your body (or a surrogate). This will usually happen after cancer treatment.

* This is a simplified overview, and is not to scale

Featured resource

Fertility and Cancer

Download PDF

This information is reviewed by

This information was last reviewed October 2022 by the following expert content reviewers: Prof Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne and Director, Gynaecology Research Centre, The Royal Women’s Hospital, VIC; Dr Sally Baron-Hay, Medical Oncologist, Royal North Shore Hospital and Northern Cancer Institute, NSW; Anita Cox, Cancer Nurse Specialist and Youth Cancer Clinical Nurse Consultant, Gold Coast University Hospital, QLD; Kate Cox, McGrath Breast Health Nurse Consultant, Gawler/ Barossa Region, SA; Jade Harkin, Consumer; A/Prof Yasmin Jayasinghe, Director Oncofertility Program, The Royal Children’s Hospital, Chair, Australian New Zealand Consortium in Paediatric and Adolescent Oncofertility, Senior Research Fellow, The Royal Women’s Hospital and The University Of Melbourne, VIC; Melissa Jones, Nurse Consultant, Youth Cancer Service SA/NT, Royal Adelaide Hospital, SA; Dr Shanna Logan, Clinical Psychologist, The Hummingbird Centre, Newcastle West, NSW; Stephen Page, Family Law Accredited Specialist and Director, Page Provan, QLD; Dr Michelle Peate, Program Leader, Psychosocial Health and Wellbeing Research (emPoWeR) Unit, Department of Obstetrics and Gynaecology, The Royal Women’s Hospital and The University of Melbourne, VIC; Pampa Ray, Consumer; Prof Jane Ussher, Chair, Women’s Health Psychology, and Chief Investigator, Out with Cancer study, Western Sydney University, NSW; Prof Beverley Vollenhoven AM, Carl Wood Chair, Department of Obstetrics and Gynaecology, Monash University and Director, Gynaecology and Research, Women’s and Newborn, Monash Health and Monash IVF, VIC; Lesley Woods, 13 11 20 Consultant, Cancer Council WA.

Related Content