Are there special considerations before undertaking fertility preservation in women diagnosed with cancer?

Yes, there are several important factors to consider.
It is important to weigh up the benefits of fertility preservation against any detrimental effects of delaying cancer treatment for 1-2 weeks.

Other considerations are how advanced the cancer is, the woman’s overall health at the time of diagnosis and whether she is well enough to undergo an IVF treatment cycle involving an egg pickup.

It is very important to consider the particular type of cancer involved. Breast cancer is the commonest cancer during the reproductive years and may have the potential to grow when exposed to the hormone, oestrogen. Because ovarian stimulation causes high oestrogen levels, it is important to undertake steps to prevent high oestrogen levels in women with breast cancer.

The other consideration is whether fertility preservation is even a feasible option; for instance, with extremely low ovarian reserve the very low chances of obtaining usable eggs or embryos may not justify delaying cancer treatment.

For more information on ovarian reserve, see my section on AMH, Ovarian Reserve and the “Egg Timer Test”.

It is also important to bear in mind that regardless of whether egg/embryo freezing is undertaken, the use of GnRH analogues should also be considered during chemotherapy.