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(HealthNewsDigest.com) – When a woman is diagnosed with breast cancer, her immediate need is to save her life. Another extant concern is that of her future family. According to the National Cancer Institute (NCI), nearly 49,000 women in the U.S. under age 50 are diagnosed with breast cancer every year, and almost 11,000 of those are of prime child-bearing years and under the age of 40. Breast cancer is rare in younger women, but it does happen and breast cancer treatment will impact your ability to have a baby in the future. However, fertility preservation relies on the steps you take before cancer treatment in order to preserve your future family.
Impact of Chemotherapy WINFertility
Breast cancers in younger women have unique qualities that affect your window for family-planning. They are more likely to be faster-growing, higher-grade, and hormone-receptor negative, which makes them more aggressive and more likely to be treated with chemotherapy, according to the Susan G. Komen Foundation. Chemotherapy may cause your periods to stop and can damage the ovaries.
Most women go into premature menopause during chemotherapy and in younger women, their periods may return after six months or more. The treatment tends to bring their natural menopause on earlier overall and women over 40 are more likely to go into permanent menopause. For these reasons, the
window for having a family may be shortened.
Your breast surgeon and oncologist’s first mission is to eliminate your cancer and help you survive. Certain combinations of chemotherapy drugs can cause more damage to the ovaries than others. What your doctor prescribes will depend on many factors, including the type of breast cancer you have, the stage it is in, how fast it is growing, and whether it is hormone-receptor negative or positive. Have a heart to heart with your doctor about your concerns for your fertility before treatment begins and put a plan in place to protect your future family.
Fertility Preservation WINFertility
Meeting with a fertility specialist before your treatment begins will give you the opportunity to discuss a wide range of options. In many cases, patients undergoing initial treatment with lumpectomy or mastectomy will have an interval of time before they are to start post-operative chemotherapy, which allows for a fertility preservation procedure to be performed during that window of time. So, it may not be necessary for you to delay your chemotherapy in order to have such a procedure. In fact, many fertility centers are set up to expedite seeing you soon after your diagnosis is made, and new protocols have allowed for starting the fertility medications right away which saves a lot of time.
There are 2 common options for fertility preservation, oocyte (egg) freezing or embryo freezing. In either case, your ovaries are stimulated with injectable fertility medications in order to produce a number of eggs. Since many breast cancers are hormonally dependent, your doctor may decide to co-administer a medication called letrozole, which minimizes the circulating estrogen levels and may reduce the risks associated with the fertility medications in such cases.
The decision as to whether to freeze eggs or embryos depends upon the individual patient’s situation. In recent years, the technology for egg freezing has greatly improved, so the success rate of in-vitro fertilization (IVF) with frozen eggs, which are thawed and fertilized in the lab, is nearly as good as IVF with fresh eggs, which are fertilized in the lab and then frozen for a future transfer to the uterus. Making embryos requires that you have a male partner or are willing to use donor sperm to fertilize the eggs with in-vitro fertilization (IVF). Given the great strides that have been made in egg freezing, it usually is now recommended to freeze eggs, rather than create and freeze embryos. This precludes having to use donor sperm and is preferable, even if you have a partner, just in case something changes in your life situation in the future prior to using the embryos that you created. A reproductive endocrinologist (fertility specialist) can help you determine your options and will explain the procedures and the costs involved. In either case, you will need treatment in the future, when you are cancer free, to use the frozen embryos or eggs.
For those breast cancer patients who have a genetic mutation that is associated with their cancer (e.g., BRCA mutations), it is possible to perform preimplantation genetic testing on the embryos that are created in order to select embryos for transfer that don’t carry the mutation and thus significantly decrease the chances of your children having such cancers.
Costs Associated with Fertility Preservation
Unfortunately, most insurance plans will not cover the cost of fertility preservation, but there are ways to finance treatment and make it more affordable. Check to see if the state you live in covers fertility treatments. 16 states – Arkansas, California, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia—have passed laws that require insurers to either cover or offer coverage for infertility diagnosis and treatment.
Employer-sponsored fertility benefits can be life-changing for individuals that need treatment, especially those that do not live in a state that mandates fertility coverage. Without a benefit, IVF treatment can cost almost $30,000 depending on the city of treatment, medications used and genetic testing required. An employer-sponsored benefit can truly make a difference for someone not able to otherwise afford treatment. Your employer might work with a fertility benefit management company to help employees make the most efficient use of their benefit dollars.
If your employer does not offer a fertility benefit, you can work directly with a fertility benefits management company to access treatment and medication bundles which include IVF treatment and medications at a reduced “pay-as-you-go” price.
Receiving a breast cancer diagnosis can be devastating. However, having a well thought out plan between you and your doctor can ease some of the additional stress and provide a clear pathway to preserving your future family. WINFertility