Can I have children after overcoming cancer?

• Instituto Bernabeu’s medical team studies the fertility of women undergoing cancer treatments
• Spain has around 285,000 new cases of cancer per year
• Experts recommend oocytes cryopreservation and report on the risks associated with post-cancer pregnancies

Predictions indicate that more than 285,000 Spanish people will contract cancer by 2024. Despite vital research into the fight against this disease, the numbers are growing and it is affecting more and more people of all ages, suddenly flooding their lives with doubts and complications. Among them, one of the most frequently asked questions to doctors revolves around how cancer affects their present and future fertility. Instituto Bernabeu’s medical team resolves the main doubts associated with this growing social reality.

Can I get pregnant after overcoming cancer? The answer is yes, but not in all cases. Let us explain.

In most cases, pregnancy after cancer treatment is safe for both mother and baby and does not increase the risk of the disease returning. However, factors such as the age of the patient, the type of treatment they have undergone and the cancer they have had are relevant in the pursuit of pregnancy.

‘Oncological treatments such as chemotherapy, surgery and radiotherapy can affect subsequent fertility depending on the patient who undergoes these therapies,’ acknowledges Dr Lydia Luque, gynaecologist specialising in reproductive medicine and medical coordinator of the Instituto Bernabeu in Albacete. Fortunately, advances in the area of oncological treatment have allowed ‘a spectacular increase in survival and subsequent quality of life’ in a wide variety of clinical cases, she explains.

In 2023, a total of 279,260 new cases were diagnosed according to figures from the Spanish Association Against Cancer. Moreover, it does not distinguish between genders: according to the Spanish Society of Medical Oncology, up to the age of 80, men have a 40.2% risk of developing cancer and women a 28.0% risk. Men can also suffer infertility after overcoming a tumour, but the chances are higher in women.

One of the most worrying cancers for female fertility is breast cancer. According to the Spanish Association Against Cancer, around 36,000 new cases of breast cancer are diagnosed in Spain every year, being the second most detected type after colon and rectum cancer, but the first among women. Many women facing this difficult situation are young or very young and have not yet started a family.

Once the corresponding oncological treatments have been completed, women can attempt a spontaneous pregnancy and, in the event of difficulties, seek the support of a team of professionals to carry out assisted reproduction treatment to maximise their chances. However, national and international oncological disease expert committees urge doctors to inform patients, prior to cancer treatment, of what is considered by specialists to be the most effective option in most cases: oocyte cryopreservation.

‘Oocyte cryopreservation, commonly known as ‘egg freezing’, is a valid solution both for tumour diseases, whatever their origin, and for any woman diagnosed with a disease that requires treatments that may affect ovarian function. The aim is to increase her subsequent probability of becoming a mother with her own eggs,’ explains Dr Luque.

It is advisable to freeze oocytes before receiving oncological treatments as these treatments can affect and damage ovarian function. The probability of pregnancy will be lower in women who come years after having overcome the tumour than in women who cryopreserve their oocytes before cancer treatment. This is because their oocytes are older and have been subjected to the side effects of the tumour treatment and may be damaged. In many cases, it is not the tumour itself that affects fertility but the therapies used to treat it. It should be noted that oocyte cryopreservation treatments are brief and do not worsen the prognosis of cancer patients.

‘The procedure consists of performing a controlled ovarian stimulation, in which the patient is administered daily doses of subcutaneous hormones for 8-10 days, we assess the ovarian response by means of vaginal ultrasound scans (2 or 3) and, finally, we collect the oocytes via vaginal ultrasound-guided. The mature oocytes obtained are cryopreserved on the same day. In total, an average of 10-12 days elapse between the start of the stimulation and the collection’, explains the medical team at Instituto Bernabeu.

Can a foetus inherit cancer?

Another question answered by the medical team focuses on whether it is possible for a child to inherit cancer, but only a minority of tumours are actually inherited. The vast majority of women who have had tumours will not pass that cancer on to their offspring.

‘Most tumours are not hereditary, but is the risk that would be inherited, not the tumour. In the case of breast cancer, only 10% of tumours are genetic, but in no case would the tumour be inherited,’ explains Dr Luque.

In addition, in cases of hereditary tumours, advances in technology allow for pre-implantation embryo diagnosis, with the aim of detecting possible chromosomally affected embryos. This would allow the selection of healthy embryos before embryo transfer. The Instituto Bernabeu specialist concludes that ‘there is accumulated scientific evidence’ that shows that the children of people who have had cancer ‘have no greater risk of contracting the disease’ than any other child.

Egg and sperm preservation in cancer patients.

Due to the increase in the appearance of breast cancer in young women and the fact that thanks to advances in its treatment, a high survival rate is being achieved -but at the cost of losing fertility as a consequence of chemotherapy and/or radiotherapy-, the Rafael Bernabeu Foundation, Instituto Bernabeu’s Social Work, offers free oocyte preservation prior to cancer treatment, in order to recover the possibility of becoming a mother after the treatment, offers, free of charge, the preservation of oocytes prior to cancer treatment, in order to recover the possibility of becoming a mother after the therapy, including ovarian stimulation, oocyte collection and subsequent freezing and storage, so that after the cure of the mammary lesion she can opt for motherhood.

Likewise, it offers male patients the freezing of their sperm prior to their cancer treatment, assuming the entire cost of the process of preservation and its custody.

Thousands of people fight cancer on a daily basis and at Instituto Bernabeu we stress the importance of research to facilitate the daily lives of those who suffer from it and try to find solutions through science. To download explanatory video clips by Dr Lydia Luque click HERE