Having ovarian cancer and the resulting treatment can affect your fertility. You may be single or in a relationship. You may not be sure if you want children in the future, or you may be diagnosed just at the age when you were planning to start a family. This can make this type of cancer even harder to cope with.
Your ovarian cancer treatment and fertility
Ovarian cancer treatment may result in the removal of both ovaries and Fallopian tubes, and the uterus (womb). This means you won’t be able to become pregnant naturally but you may still have other options.
If the cancer is caught early, with only one ovary involved, or if you have a germ cell tumour of the ovary, it might be possible to preserve the uterus and the unaffected ovary may remain fertile. However, chemotherapy may damage your remaining ovary or increase your risk of an earlier menopause.
“I went on to have a baby with IVF after my tumour was removed and chemo. I would like women to know that in some cases it may still be able to have their own children. Talk to your medical team about different options available.”Joanne, diagnosed age 33
Talking about fertility and ovarian cancer
The main priority for your ovarian cancer treatment is to save your life. It is important to talk about your fertility needs before treatment starts in order to help you, your partner and your medical team plan the most appropriate treatment for you while being realistic about your prospects of remaining fertile. However, this may not be possible. For example, if treatment has to start immediately or you have been diagnosed through emergency surgery, you may want to talk about your options after the treatment when you feel ready. If you have a partner it is usually a good idea to include them in discussions about fertility.
Your CNS or consultant can advise whether to seek further fertility counselling and provide referral letters for your GP and other fertility services.
In vitro fertilisation (IVF)
If you did not have a total hysterectomy as part of your treatment if may be possible for you to explore IVF.
IVF is the process in which eggs are fertilised by sperm (from your partner or a donor) and then placed into your womb. Depending on your diagnosis it may not always be possible to delay treatment to do so. In this case you can still use a donor egg.
The NHS will cover the cost for some IVF. Speak to your CNS or consultant who can support you to get a referral from your GP. If you are not eligible for NHS funding or you decide to pay for IVF you can contact a private clinic. Private fertility treatment costs vary across the UK.
The Human Fertilisation and Embryology Authority (HFEA) regulates and licenses fertility clinics. You can find out more about IVF techniques, how long treatment may take, how to find a clinic and the costs on their website www.hfea.gov.uk. Most fertility centres advise that you wait for two years after treatment ends before trying to have a baby.
If you had a total hysterectomy with your uterus and ovaries removed or after discussions with your partner, family and cancer team (and possibly a fertility specialist) you decide IVF is not a realistic option for you, you may want to consider other options for having a child after ovarian cancer.
Surrogacy is where another woman (the surrogate) carries your baby through pregnancy for you.
Traditional or partial surrogacy is where you partner’s or a donor’s sperm is placed in the surrogate’s vagina. This is usually done by artificial insemination and can be done in a clinic or with an insemination kit at home.
Host (or full) surrogacy is when an embryo created from your partner’s or a donor’s sperm and an egg previously harvested from you or a donor is placed inside the uterus of your surrogate. This type is much more complicated than traditional surrogacy.
The legality and costs of
surrogacy are complicated. You can visit www.surrogacyuk.org for
comprehensive and accurate information.
Adoption and fostering
Through adoption you would assume the parenting of a child from that child’s biological or legal parent(s). All rights and responsibilities are transferred permanently to the adopting parents.
Fostering is a way of providing a home for a child at times when they are unable to live with their birth family. This includes providing care in emergencies and for longer periods. The child will remain in touch with their biological family and hopefully will return home. Although most adoption agencies allow cancer survivors to adopt, some require a letter from a doctor certifying good health, and others may require a certain amount of time to pass after you have completed treatment for cancer.
You can visit CoramBAAF Adoption& Fostering Academy for more information.
If you decide not to have children
Being unable to have children naturally can be very difficult to deal with. However, you might not have wanted children in the first place or after having discussed fertility options with your partner, family, and professionals you may choose to enjoy life without having children.
Coping with your emotions
It may not be until after your treatment has finished that you have the time and ability to process your feelings. You might find that any relief related to finishing treatment is replaced by anger or grief at not being able to become a parent. You may feel isolated and unable to share your emotions with your partner and your family. Some women find it hard to feel joy for friends and family who can have children and this might make them feel guilty. This may put a strain on your relationships but it is important to share these feelings rather than keeping them to yourself.
You may find it helpful to:
- Speak to a professional counsellor, providing you with a safe and non-judgmental space to explore your feelings
- Talk to others who have been through similar experiences
- Visit ovarian cancer charity websites to read blogs or online forums, or call a charity support line
“For me the fertility issue wasn’t a big deal, at the time I was very ambitious, I was at uni, I couldn’t imagine having kids anyway. Now I think it’s a relief, because it takes away that pressure. My friends get asked when they’re getting married and going to have kids. In some way it’s quite liberating, I’ve just got to worry about myself.”Hannah, diagnosed aged 19