Female options after cancer treatment

Fertility options after cancer treatment may be limited. Your ability to become pregnant depends on the effects of cancer treatment on fertility, your age and whether you have been affected by premature ovarian insufficiency or early menopause. Options to consider include:

• conceiving naturally
• using eggs or embryos you harvested and stored before treatment, implanted into either your body or a surrogate
• freezing eggs or embryos after treatment ends for later use (if your ovaries are still working)
• using donor eggs or embryos.

Checking fertility after treatment

Before trying to conceive, you may want to do some tests to see how your fertility has been affected. While there is no reliable way of checking how treatment has affected your fertility, these tests provide your fertility specialist or reproductive endocrinologist with some information. You can ask them how much the tests  will cost.

Natural conception

You may be able to conceive naturally after finishing cancer treatment if your ovaries are still releasing eggs and you have a uterus. If fertility tests suggest it may be possible for you to get pregnant, your medical team will encourage you to try for a baby naturally.

Even if your periods return after chemotherapy or pelvic radiation therapy, there is a high risk of early menopause. If menopause is permanent, you will no longer be able to conceive naturally.

Uterus transplant is being studied in clinical trials. Talk to your doctor about the latest research and whether there are any suitable clinical trials for you.

Donor eggs and embryos

If after cancer treatment you have early menopause but a healthy uterus, you could try for a pregnancy using eggs or embryos donated by another person. You may be able to use eggs or embryos from overseas, but there are strict rules about importing them into Australia. Donors cannot be paid but you can cover (reimburse) their medical expenses.

Using donor eggs

In most cases, eggs are donated by a family member or friend. Your fertility clinic may have an egg bank, but there is usually a long waiting list. All donors are required to have blood tests, answer questions about their genetic and medical information, and have counselling.

After the eggs are collected from the donor, they are combined with sperm from your partner or a donor using IVF. The embryo is frozen until needed.

Using donor embryos

Donor embryos usually come from people who still have frozen embryos after they’ve had successful IVF treatment. Embryos may be donated for ethical reasons (instead of discarding the embryos) or compassionate reasons (to help someone with infertility).

If you use a donated embryo, you will take hormones to prepare your uterus for pregnancy. When your body is ready, the embryo will be thawed and implanted into your uterus using IVF. A child born from a donated embryo is deemed to be the child of the birth mother. Donors have no legal or financial obligation to the child. It is common to have counselling before beginning the IVF process.

Finding information about the donor

In Australia, fertility clinics can only use eggs and embryos from donors who agree (consent) that people born from their donation can find out who they are. This means that the donor’s name, address and date of birth are recorded.

Once donor-conceived people turn 18, they are entitled to access identifying information about the donor.

In some states, a central register is used to record details about donors and their donor-conceived offspring. Parents of donor-conceived children, and donor-conceived people who are over the age of 18, can apply for information about the donor through these registers. In other states and territories, people who want information about their donor can ask the clinic where they had treatment.

It is important to discuss possible issues for donor-conceived children with a fertility counsellor.