Having Children After Breast Cancer
Breast cancer treatment and fertility
Young women with breast cancer may be concerned about loss of fertility (the ability to have a natural pregnancy).
Chemotherapy can damage the ovaries.
Both chemotherapy and hormone therapy can cause irregular menstrual periods, and chemotherapy may stop periods altogether. Chemotherapy also tends to bring on natural menopause earlier than normal, especially in women who are over 40 during treatment [240].
Because of the danger of birth defects, women should not become pregnant while getting chemotherapy or taking hormone therapy [2].
Chemotherapy and fertility
With chemotherapy, the loss of periods may be permanent. Some chemotherapy combinations are less likely to cause permanent menopause than others.
Women under 40 at the time of treatment are more likely than older women to have their periods return after chemotherapy [240]. The risk of permanent menopause increases with age [240].
Hormone therapy and fertility
With tamoxifen, periods may continue, or they may stop and then return after treatment ends (although they may be irregular).
If ovarian suppression is given along with tamoxifen or an aromatase inhibitor, periods stop temporarily and return after treatment ends.
Hormone therapy doesn’t permanently damage the ovaries. For most young women, periods return once they complete hormone therapy.
However, hormone therapy is taken for 5-10 years and during this time, natural fertility declines. This shortens the window of time to have children. And, if a woman also gets chemotherapy, menopause may come sooner than it would have naturally.
Taking a break from hormone therapy to have a child
A recent study looked at women ages 42 and younger who had stage I-III hormone receptor-positive breast cancer and wished to try and have a child [109]. The women had been taking hormone therapy (tamoxifen (with or without ovarian suppression) or an aromatase inhibitor with ovarian suppression) for 18-30 months [109].
The women in the study paused hormone therapy for up to 2 years to try to have a child [109]. After that time, women went back on hormone therapy so they could complete their planned 5-10 years of treatment [109].
After 3 years of follow-up, findings showed no evidence of an increased rate of breast cancer recurrence (breast cancer returning in the breast) or metastasis (breast cancer spreading to other parts of the body) in the women who paused hormone therapy [109,241].
If you’re on hormone therapy and wish to have a child, talk with your oncologist about your risk of breast cancer recurrence and whether it makes sense for you to take a break from treatment to try to have a child (and then return to hormone therapy).
Other drug therapies and fertility
There are a number of new drug therapies for early breast cancer, including antibody-drug conjugate therapy, CDK4/6 inhibitor therapy, immunotherapy and PARP inhibitor therapy. We don’t yet understand the impact these new therapies might have on future fertility.
Preserving fertility
Storing eggs
Before treatment begins, you can help preserve your ability to have children in a few ways.
The most common way to preserve fertility is to store your eggs (fertilized or unfertilized) before chemotherapy begins. Some of your eggs are collected, frozen and stored. The eggs may be fertilized by sperm from a spouse, partner or donor. Or you may store unfertilized eggs, which don’t require a sperm donor.
After treatment, the eggs can be thawed. If they were frozen unfertilized, they are fertilized. The fertilized eggs are then implanted into the uterus.
Breast cancer treatment may be delayed while eggs are collected (and if a sperm donor is needed to fertilize the eggs before they are stored). Studies suggest these treatment delays are not long and should not affect survival [242-245].
The fertility drugs used to stimulate the ovaries in order to collect the eggs do not appear to affect the risk of breast cancer recurrence [242-245].
Learn about insurance coverage and financial assistance for fertility services.
Protecting the ovaries
Chemotherapy attacks fast-growing cells. These include cancer cells as well as healthy cells in other parts of the body, like the ovaries.
Drugs like goserelin (Zoladex), leuprolide (Lupron) and triptorelin (Trelstar) can shut down the ovaries during chemotherapy. Studies have shown these drugs may protect the ovaries from damage during chemotherapy, lower the chances of early menopause and help preserve fertility [246-248].
Ovarian suppression with goserelin or leuprolide is also part of breast cancer treatment for some premenopausal women with hormone receptor-positive early breast cancer. Some women may start ovarian suppression before chemotherapy begins. This not only starts their hormone therapy, but also may protect their ovaries.
Talking with a fertility specialist
If you wish to have a child after breast cancer treatment, discuss your options with your health care provider (and if possible, a fertility specialist) about your options before making treatment decisions.
Meeting with a fertility specialist as early as possible (before surgery) offers the widest range of options.
Insurance and financial assistance for fertility services
Insurance coverage for fertility services varies widely. Check with your insurance company to find out which procedures are covered in your policy.
Organizations such LIVESTRONG Fertility offer financial help if your insurance company doesn’t cover these services.
LIVESTRONG Fertility also offers information on fertility options.
Learn more about other financial assistance programs.
Pregnancy and breast cancer survival
Having a child after completing breast cancer treatment doesn’t appear to be linked to worse survival for women [110-115].
Your health care provider or a fertility specialist can discuss the best timing of a pregnancy for you based on your breast cancer treatment.
| For a summary of research studies on pregnancy after breast cancer, visit the Breast Cancer Research section. |
Breastfeeding after breast cancer treatment
Some treatments for breast cancer can impact your ability to breastfeed.
If you had surgery to only one breast, breastfeeding from your untreated (opposite) breast should be fine.
Don’t breastfeed if you are being treated with radiation therapy, chemotherapy, hormone therapy, HER2-targeted therapy or other drug therapies.
After lumpectomy and radiation therapy
Breastfeeding from the treated breast after a lumpectomy plus radiation therapy may be difficult. Both the surgery and the radiation therapy can harm the tissue needed for breastfeeding.
While feeding from the treated breast is possible (and the milk is safe for the baby), it’s not common, and the amount of milk produced may be greatly reduced [116].
Other concerns about having a child after breast cancer treatment
Pregnancy after breast cancer treatment doesn’t appear to be linked to worse survival, but some women may have other concerns about having a child.
Women who have a strong family history of breast cancer may worry about passing on an inherited genetic mutation that increases risk.
Women with a high risk of breast cancer recurrence (a return of breast cancer) may worry about having a recurrence while pregnant or after delivery.
Having a child is a personal decision. However, if you have any concerns, it may be helpful to talk with your health care provider or a mental health provider and to seek support from your family, friends and other loved ones.
Learn more about breast cancer concerns for family members.
Learn more about inherited genetic mutations and breast cancer risk.
Birth control after breast cancer treatment
Although chemotherapy and hormone therapy may temporarily stop periods, not all women will go into menopause. So, if you were premenopausal before breast cancer treatment, you may still become pregnant after treatment.
Current or recent use of birth control that contains hormones (such as birth control pills) is linked to a slight increase in the risk of breast cancer [238-239]. For women who’ve had breast cancer, there are concerns about using birth control that contains hormones and the risk of recurrence (a return of breast cancer) [117].
So, it’s important to talk with your provider before you begin using birth control containing hormones.
Learn more about birth control and breast cancer risk.
Methods of birth control that don’t contain hormones
Birth control options that don’t contain hormones include [117]:
- Copper IUDs (intrauterine devices that don’t contain hormones)
- Condoms or other barrier method
Talk with your health care provider about which type of birth control is best for you, including its benefits and risks.
Support for young breast cancer survivors and their families
Young women with breast cancer can feel isolated. Because most women with breast cancer are older, it’s easy to feel alone, even among other women with breast cancer.
A support group tailored to younger women with any type of cancer may be more helpful than one for women of any age with breast cancer. Younger women need to be able to share their thoughts and feelings with women who are at the same stage of life and may have similar concerns about fertility and having children.
Learn more about social support for young women diagnosed with breast cancer.
Learn more about social support for spouses, partners and other family members.
Learn more about social support for children.
Susan G. Komen® Support Resources |
|
Updated 03/27/26
This content is regularly reviewed by an expert panel including researchers, practicing clinicians and patient advocates.
