Young women and breast cancer: How to protect fertility before and after treatment?

Breast cancer can affect fertility, but with right steps, young women can protect their chances of having children in the future. (Image: Pexels)

Breast cancer occurs when abnormal cells grow in the breast, often forming a tumour. According to the National Cancer Institute (NCI), it starts in the breast tissues, usually in the ducts or lobules. Each breast has 50 to 20 lobes,made up of lobules and milk producing bulbs. These are all connected by ducts. Most breast cancer begin in these ducts or lobules, where cells are more active and prone to change.

Women are born with a set number of eggs, and certain cancer treatments, including chemotherapy and hormone therapy, can damage or reduce that egg supply.

Dr Karishma Kirti, Consultant Breast Specialist and Oncoplastic Surgeon, informs, “The ovaries are very sensitive during cancer treatment, and once eggs are lost, they can’t be replaced,” She adds that with the right steps taken early, women don’t have to give up their dream of becoming a mother.

Not every treatment will affect fertility the same way. The risks, says Dr Kirti, depend on your age, the type and dose of chemotherapy, and whether long-term hormone therapy (like tamoxifen) is needed. “Younger women usually have more eggs and can sometimes recover better after treatment, but timing is everything,” Talking to your doctor about fertility before treatment starts gives you more options and better outcomes.

Egg or embryo freezing: This is the most common and proven method. Here’s how, Dr Kirti suggests, it works:

• You take medications for about 2–3 weeks to stimulate your ovaries

• Doctors collect your eggs

• The eggs are then frozen, either on their own or fertilised to create embryos

• Even women with hormone-sensitive cancers can safely go through this process using special protocols.

Ovarian suppression: This involves taking hormone injections that temporarily switch off your ovaries during chemotherapy. “The idea is to protect your eggs by keeping your ovaries inactive. It’s not 100% effective, but it can be used alongside egg freezing to add another layer of protection,” she says.

Ovarian tissue freezing: Still considered experimental, this method involves removing and freezing a small piece of your ovary before treatment. “Later, it might be reimplanted to try to restore fertility. This option is helpful if there’s no time to go through the egg freezing process before treatment begins,” informs Dr Kirti.

• Ask early: The fertility preservation works best when planned before the treatment starts.

• Talk to a specialist: Consult a fertility doctor, or reproductive endocrinologist. “They can help create a plan based on your age, cancer type, and treatment procedure,” Dr Kirti informs.

• Timing matters: For women on hormonal therapy, like tamoxifen, doctors may allow a temporary break later if you want to try for pregnancy.

• Look into support: some hospitals, insurance providers and NGOs, offer financial help for fertility preservation