Ask the expert - breast cancer and fertility preservation

Associate Professor Kate Stern is a fertility specialist, gynaecologist and reproductive endocrinologist based at the University of Melbourne, Royal Women’s Hospital. She is the Head of the Endocrine and Metabolic Service and Acting Head of Reproductive Services both at the Royal Women’s Hospital Melbourne and also the Clinical Director and Head of Clinical Research at Melbourne IVF. We sat down with Kate to talk about breast cancer in young women and its impact on fertility.

What is the biggest issue facing young women with breast cancer and fertility?

The fact that some are not informed of the risks chemotherapy poses to their fertility and the many options available to them. A lot of young women diagnosed with breast cancer will have chemotherapy, which is very effective against cancer cells, but can reduce the total number of eggs. It’s vital for young women to consider future fertility as part of their treatment regimen.

How many women are not being informed?

Research conducted by BCNA as part of the development of a new resource for fertility preservation showed one in six young women were not informed of their fertility options.

Do they have time to consider their fertility options after diagnosis?

There is always time to have a discussion about fertility preservation, and almost always time to proceed with options including egg freezing.  Sometimes, there may be time for more than one attempt at fertility preservation prior to starting chemotherapy. It is critical women have all the facts they need to make informed decisions that deliver the best possible outcome.

What’s the biggest obstacle you face as a fertility specialist with this issue?

The most important thing is ensuring young women receive all the relevant information. It’s so important to get this advice early in the piece because there are lots of options available to help preserve their fertility. They include injections during chemotherapy, egg and embryo freezing and even freezing ovarian tissue for future use.

Is it safe for young women to have babies after their treatment?

For most young women diagnosed with breast cancer, we know that having a baby in the future is not risky. And it doesn’t matter whether the tumor was receptor positive or receptor negative. Of course, everyone’s situation is different. But we know for most young women who have low-risk disease, it’s safe to have a baby and it’s safe to have fertility treatment as well.

What about women living in rural Australia?

We can organise phone conversations, use telehealth and send information to make sure women are well-informed. A woman’s postcode is not, and should not, be a barrier to getting the best treatment.  We have transport services now well – organised so geography should not stop women getting the advice and treatment they need.

Dr Kate Stern was involved in the development of our fertility preservation tool which is available on BCNA’s My Journey online tool.

Issue 86
Autumn 2020