Cancer & Fertility Part 2: Fertility Care After Treatment Ends

Coming off of birth control with acne-prone skin

A few weeks ago, in part one we discussed the important questions to ask about your fertility options before cancer treatment begins. However, protecting your fertility before cancer treatment is only one part of the equation. Finding natural and safe fertility solutions after cancer treatment ends, is equally as important, and can often be tricky to navigate. 

In part two of this discussion, we’ll be going through important questions to consider before engaging in fertility care after cancer treatment has ended. We’ll also quickly review commonly used natural preconception treatments that may be risky with a history of cancer. 

Keep in mind that your age, cancer history, other medical history, and ongoing treatment will all play a role in determining what is most safe and effective for you specifically on your fertility journey. Always speak with a Naturopathic Doctor well-versed in oncofertility prior to adding any new therapies into your routine. 

important questions to consider

Did you have a hormone-sensitive cancer?

Many fertility and preconception treatments are aimed at restoring healthy hormone levels. Even natural fertility therapies include the use of herbs that impact circulating levels of estrogen and progesterone. With a history of a hormone-sensitive cancer (think breast cancer, endometrial cancer, ovarian cancer, cervical cancer), treatments need to be modified, so we do not increase hormone exposure, and therefore increase the risk of cancer recurrence. Always ensure that if you are adding any natural or conventional therapies to your routine, you understand both the short and long-term risks as it relates to your cancer history.

Did you have cancer of your reproductive organs? Or did you have surgery or radiation near your reproductive organs?

If you had cancer of your reproductive organs, surgery removing/near your reproductive organs, or radiation in the abdominal/pelvic region, this is of course going to impact your ability to conceive naturally. There are so many amazing options for fertility preservation in these cases before cancer treatment begins. To learn more about that, click here. Post-treatment support will depend on what method of fertility preservation you chose, which specific organs were affected, and if you had reproductive cells frozen. 

Did you have your reproductive cells (sperm/egg) frozen prior to treatment? 

If you had your reproductive cells frozen prior to your cancer treatment, that’s excellent. Typically with preconception and fertility support there is a heavy emphasis on optimizing egg and sperm health prior to trying to conceive. Obviously, if your cells have already been frozen, you can skip this part of treatment!

What’s your timeline? 

Unfortunately due to the toxic nature of cancer treatments, women may experience early menopause once treatment has ended. In particular, radiation to the abdominal/pelvic region can damage a woman’s ovaries and cause premature ovarian insufficiency. This means that if you want to try to conceive naturally, you need to realistically consider your timelines. It is still possible to carry a pregnancy in the perimenopausal stage, however it is much more difficult and carries more risks. 

Are you currently on any hormone therapies?

Last but certainly not least, are you taking any hormone therapies to prevent cancer recurrence? If you answered yes, and you want to start trying, it’s important you speak with your doctor right away. These drugs may be toxic to a fetus, and may require a short period of discontinuation. Always, always speak to your oncologist before stopping or changing any medications. 

natural therapies to avoid

Now that we’ve gone over questions to consider, let’s tackle the elephant in the room: natural therapies are not always safe. Unfortunately, there’s a big problem right now in which people equate natural with safe. Natural therapies such as supplements and herbs can pose risks to your health when used improperly and without considering your health history. When it comes to preconception and fertility support with a cancer history, you can never be too careful. Here is a general overview of common preconception natural therapies that you should be cautious of with a cancer history: 

  • Prenatal Vitamins. Although prenatals in themselves are not dangerous, almost all prenatal formulas contain copper. With a history of cancer, copper should be avoided, as it is an angiogenic agent that can promote the growth of tumours. Prenatal vitamins are obviously important for healthy conception and pregnancy, so It’s vital that you work with an ND who can recommend safe support, and can continuously monitor you, to help reduce this risk while taking a prenatal vitamin. 

  • Folate. Folate is sort of a double-edged sword with cancer, in that too much or too little can contribute to cancer development and recurrence. In individuals with a history of cancer, folate is generally discouraged. Folate is an essential nutrient in preconception and pregnancy, so it’s important you navigate folate supplementation extremely cautiously and with the help of a naturopathic or medical doctor. 

  • Hormone Balancing Herbs. As mentioned above, if you have a history of a hormone-sensitive cancer, hormone balancing herbs should be strictly avoided. This can be tricky when dealing with premature ovarian failure, or amenorrhea after cancer treatment. Luckily there are other options available, and an ND who is well-educated in oncofertility should be able to provide effective alternatives to help optimize your fertility without putting you at risk.

As a general rule, don’t start any natural therapy without consulting your Naturopathic Doctor first. 

want to learn more about your options?

Remember, when it comes to oncofertility, there’s no such thing as a dumb question, and it never hurts to exercise extreme caution! If you’ve completed your cancer treatments and are considering how to best support your fertility, there are options available to you. It’s important to work with an ND who has additional training in oncofertility, and who understands your unique risk factors. If you have a cancer history and want to work with an ND, but are unsure of what to look for in your doctor, check out our post here

dr alessia milano

Ready to make a change?

If you would like to learn more about supporting your fertility before or after your cancer treatment, I’m here for you.

With loving compassion,

Dr. Alessia Milano ND