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Female options before cancer treatment

In this section we look at ways you can preserve your fertility before starting cancer treatment. It’s ideal to discuss the options with your cancer or fertility specialist or oncofertility specialist at this time.

Keep in mind that these methods don’t work all of the time.

Learn more about:

Discussing your options
Ways to preserve fertility in females
How in-vitro fertilisation works

Discussing your options

If you didn’t have an opportunity to discuss your options before starting cancer treatment, you can still consider your fertility later, but there may not be as many options available.

For more on discussing your options, see Checking fertility after cancer treatment, Other ways to be a parent and Not having a child.

Ways to preserve fertility in females

Wait and see

What this is	when no method is used to preserve fertility
When this is used	when you don’t have time to consider fertility preservation when you choose to start cancer treatment immediately
How this works	requires no action
What to consider	more likely to lead to premature ovarian insufficiency
Pregnancy rate	depends on age and cancer treatment

Freezing eggs or embryo freezing (cryopreservation)

What this is	the process of collecting, developing and freezing eggs or embryos as part of an in-vitro fertilisation (IVF) cycle
When this is used	when you want to store eggs or embryos for use in the future – they can be stored for many years when you are ready to have a child, the frozen egg will be fertilised using IVF or the embryo will be implanted in your uterus
How this works	egg and embryo freezing is part of IVF – the most common and successful assisted reproductive technology for preserving female fertility one cycle of IVF can take 2–3 weeks egg collection is done in an operating theatre as a day procedure
What to consider	need time to have IVF before cancer treatment – your cancer specialists will advise how quickly treatment should begin ask the fertility clinic about the cost of storing eggs and embryos need sperm from a partner or donor sperm to create an embryo to use a frozen embryo, you will need consent from the sperm donor talk with your fertility specialist about whether to freeze eggs, embryos or a mix of both legal limits on how long eggs and embryos can be stored are different in each state and territory; ask the fertility clinic for details
Pregnancy rate	freezing eggs works nearly as well as freezing embryos for every 10 eggs frozen, you can expect to get 1–4 embryos depending on age, the success rate of the fertility clinic and the stage at which the embryos are stored at, there may be a 25–40% chance per cycle of a frozen embryo developing into a pregnancy

Freezing ovarian tissue (cryopreservation)

What this is	the process of removing, slicing and freezing tiny pieces of tissue from an ovary so it can be used later
When this is used	if treatment needs to start immediately if taking hormones to encourage egg production is unsafe if there is a high risk of infertility if the person hasn’t gone through puberty can be used in addition to egg freezing
How this works	tissue is removed from your ovaries during keyhole surgery (laparoscopy); if you have abdominal surgery as part of cancer treatment, tissue can be removed at this time tissue is frozen until it is needed when needed, the tissue is thawed and put back (grafted) into the ovary tissue may produce hormones and eggs may develop
What to consider	risk that storing tissue before treatment begins means it will contain cancer cells, and you may not want to put this tissue back into your body; risk is higher for people with leukaemia legal limits on how long ovarian tissue can be stored are different in each state and territory ask your fertility clinic how much you will have to pay for storage
Pregnancy rate	there have been a small number of births worldwide from ovarian tissue removed before puberty, and several births from ovarian tissue removed after puberty about a third of people who have tried to use ovarian tissue to become pregnant have been successful

Ovarian transposition (oophoropexy)

What this is	surgery that moves one or both ovaries to prevent damage to the ovaries during radiation therapy
When this is used	when one or both ovaries are in the path of radiation therapy limits how much radiation the ovaries receive
How this works	one or both ovaries are moved away from the field of radiation and stitched in place put back in place after radiation therapy ends
What to consider	procedure may cut off blood supply, causing damage to the ovaries
Pregnancy rate	depends on your age, the amount of radiation that reaches the ovaries and if you start menstruating again

Fertility-sparing surgery (e.g. trachelectomy, unilateral-salpin oophorectomy)

What this is	trachelectomy removes part or all of the cervix and keeps the uterus, fallopian tubes and ovaries in place unilateral-salpingo oophorectomy removes only 1 ovary
When this is used	trachelectomy is for small tumours found only in the cervix unilateral-salpingo oophorectomy is for early-stage cancer found only in 1 ovary
How this works	the uterus is stitched tight with a small opening to allow blood to pass out during a period and for sperm to enter
What to consider	risk of miscarriage and premature birth; may have a stitch placed in what remains of the cervix to reduce the risk
Pregnancy rate	number of births increasing

GnRH analogue treatment (ovarian suppression)

What this is	gonadotropin-releasing hormone (GnRH) analogue is a long-acting hormone that stops the ovaries making oestrogen for a short time may protect eggs from being damaged
When this is used	at least 1 week before chemotherapy starts, continuing until chemotherapy finishes
How this works	hormone injections given 7–10 days before chemotherapy starts or during the first week of treatment, then every month or every 3 mon hs during chemotherapy
What to consider	backup to other fertility preservation options can affect bone density if used for more than 6 months
Pregnancy rate	studies show that treatment is suitable for young women with breast cancer but there is no evidence for other types of cancer

Read personal stories from women who have been diagnosed with cancer while pregnant

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Key resource

Download a PDF booklet on this topic.

Fertility and Cancer

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This information was last reviewed in October 2022. View who reviewed this content.

Prof Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne and Director, Gynaecology Research Centre, The Royal Women’s Hospital, VIC; Dr Sally Baron-Hay, Medical Oncologist, Royal North Shore Hospital and Northern Cancer Institute, NSW; Anita Cox, Cancer Nurse Specialist and Youth Cancer Clinical Nurse Consultant, Gold Coast University Hospital, QLD; Kate Cox, McGrath Breast Health Nurse Consultant, Gawler/ Barossa Region, SA; Jade Harkin, Consumer; A/Prof Yasmin Jayasinghe, Director Oncofertility Program, The Royal Children’s Hospital, Chair, Australian New Zealand Consortium in Paediatric and Adolescent Oncofertility, Senior Research Fellow, The Royal Women’s Hospital and The University Of Melbourne, VIC; Melissa Jones, Nurse Consultant, Youth Cancer Service SA/NT, Royal Adelaide Hospital, SA; Dr Shanna Logan, Clinical Psychologist, The Hummingbird Centre, Newcastle West, NSW; Stephen Page, Family Law Accredited Specialist and Director, Page Provan, QLD; Dr Michelle Peate, Program Leader, Psychosocial Health and Wellbeing Research (emPoWeR) Unit, Department of Obstetrics and Gynaecology, The Royal Women’s Hospital and The University of Melbourne, VIC; Pampa Ray, Consumer; Prof Jane Ussher, Chair, Women’s Health Psychology, and Chief Investigator, Out with Cancer study, Western Sydney University, NSW; Prof Beverley Vollenhoven AM, Carl Wood Chair, Department of Obstetrics and Gynaecology, Monash University and Director, Gynaecology and Research, Women’s and Newborn, Monash Health and Monash IVF, VIC; Lesley Woods, 13 11 20 Consultant, Cancer Council WA.

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