Making decisions

It’s best to talk about ways to preserve or protect your fertility before cancer treatment begins.

Get expert advice – Most people find it helpful to talk to a fertility specialist about their fertility options. Ask your cancer specialist whether you should see a fertility specialist or oncofertility specialist. You can also get a referral from your general practitioner (GP). As well as explaining your fertility options, these specialists can help with contraception and hormone management to prevent ovulation during cancer treatment. It’s best to see a fertility specialist as soon as possible after diagnosis to prevent any delays to treatment

Ask questions – It’s important that you feel comfortable enough to ask about the possible impact of different cancer treatments on your fertility, the possible risks of having treatment to preserve your fertility and the risk of delaying treatment to have fertility treatment. You may find it helpful to plan some questions in advance and to take notes during the discussion.

It’s your decision – After a cancer diagnosis, you may feel too overwhelmed by decisions about treatment to think about fertility. Or you may be asked to make fertility decisions before you’ve given much thought to whether you want to have a child in the future. Even if you think, “But I don’t want kids anyway” or “My family is complete”, you may be encouraged to consider as many fertility options as possible to keep your choices open for the future. These decisions are  personal, and you need to feel comfortable with your choices.

What to consider when making decisions

After a cancer diagnosis, you may need to make decisions about your fertility. These decisions can be difficult, particularly if you have several options to consider and you feel that everything is happening too fast 

Learn more about the options – Generally, people make decisions they are comfortable with – and have fewer regrets later – if they gather information and think about the possible outcomes. Ask your health professionals to explain each fertility option, including risks, benefits, side effects, costs and success rates.

Expect to experience doubts – It’s common to feel unsure when making tough decisions. Keeping a journal or blog about your experience may help you come to a decision and reflect on your feelings.

Talk it over – Discuss the options with people close to you (such as your partner, a friend or family member) or with a fertility counsellor or psychologist. Research shows that couples who make fertility decisions together are happier with the outcome, whatever it is.

Use a decision aid – A decision aid outlines the available options and helps you focus on what matters most to you. They are available online or in booklets. Breast Cancer Network Australia has developed a resource called Fertility-related choices to help younger women with breast cancer make fertility-related decisions.

The main costs of fertility treatment

Fertility preservation can be expensive, and this may influence your decision-making. The cost of specialists and private clinics vary across Australia. You may also be able to have treatment at a fertility unit in a public hospital or a clinic that provides discounted fertility treatment for cancer patients. Ask your fertility clinic about costs.

Depending on the treatment you have, costs may include:

• fertility specialist consultations – ask if they offer a discount for people diagnosed with cancer
• medicines and blood tests
• fees for procedures (e.g. the different steps in the IVF cycle for egg or sperm collection, preimplanation genetic testing and implantation of embryos after treatment)
• day surgery, operating theatre and anaesthetist fees
• egg, sperm and embryo storage (cryopreservation) – ask your clinic about up-front payments, instalment payments and ongoing fees.

How much you have to pay will depend on whether you are a public or private patient. If you are a private patient, there may be Medicare rebates for some of these costs. Ask your fertility specialist for a written estimate of their fees and any Medicare rebates. Ask your private health fund (if you belong to one) what costs they will cover and what you’ll have to pay – some funds only pay benefits for services at certain hospitals.

Medicare will cover the cost to see a specialist only if you have a referral. The referral should list both you and your partner so you can claim the maximum benefit.