OB-GYN (Obstetrician-Gynecologist) Questions Chemotherapy

Is pregnancy possible after chemotherapy?

My sister is currently in breast cancer remission! We are all extremely happy for her, but she is still young (32) and wants to start a family with her husband. Since she had chemotherapy and radiation done, will she be able to get and stay pregnant? What about breastfeeding? She had a mastectomy.

17 Answers

About 25% of women who have had chemotherapy for breast cancer will have resumption of menses. The factors that favor resumption of menses are youth, normal BMI, the type of chemotherapy used and whether or not they use hormonal medication like Tamoxifen following treatment. Even so, resumption of menses is not the same as fertility. Even if menses has returned, there is a greater chance of early menopause. Women in this situation need to speak with their doctors and try to balance their reproductive goals with the need to give themselves the best chance of survival. Some women are able to freeze eggs or ovarian tissue before starting chemotherapy. Some will try to freeze eggs or embryos before starting long term endocrine treatment. In any case, it is an uphill battle with many difficult decisions.
This should be discussed with her oncologist. Some women freeze eggs prior to chemo/radiation and it also depends on the regimen. Many women have gotten pregnant and carried to term after and during cancer treatment. Breastfeeding will not be possible with a mastectomy, however.
It would have been better if her eggs were collected prior to treatment and frozen for IVF. Personally, I have not seen success otherwise. Would be interested if any other doctors have
Unlike men, women are born with their eggs. Men remake their sperm every 90 days, so she should have her eggs retracted BEFORE therapy and then freeze them until she is ready for IVF.
Pregnancy should not be a problem if her periods have returned. Medical oncologists generally want you to wait 2-5 years depending on the type of cancer she had. She can still breast feed using the other breast if she wants to.
She may get pregnant and have a normal baby.
Yes, pregnancy is certainly possible after chemotherapy.

The main issue is induction of menopause or premature ovarian failure after chemotherapy. The younger the woman is at the time of chemo, however, the more likely she is to recover her ovarian function and have a baby after chemotherapy. Even with permanent ovarian failure after chemo, we can still achieve excellent pregnancy rates using In-Vitro Fertilization (IVF) with an egg donor. As with any medical treatment, there are always risks and benefits- the essential issue to explore all the possibilities and come up with an individualized treatment plan to maximize success.

Hope this helps-please call if you would like to set up a time to discuss this further.


Daniel Levine, MD
Yes still there is a chance, if her doc before chemo and radiation did cryopreservation of her ovaries, breast feeding may not be possible but I will still be happy to carry a child is she has her ovaries still functional
Yes, it is possible. I recommend a consultation with a MFM to discuss all the risks prior to conception.
It is possible, although much less likely, as chemotherapy tends to hamper fertility. Doesn't make it impossible, but your sister needs to know the odds are a bit against her at this point. Breast feeding will be fine, as the radiation does not cover the opposite breast. Best of luck!
This is a very good question!

Breast cancer is one of the most common cancer types affecting women and an increasing number of younger women are affected with this condition. Breast conservation treatment with lumpectomy generally require radiation therapy and/or chemotherapy depending on the stage of breast cancer.

In general, chemotherapy can cause a temporary decrease in ovarian function which leads to amenorrhea (skipping periods) and hot flashes. With time, periods can resume and many women are able to achieve pregnancy.

The more important questions is, "Was the original cancer sensitive to estrogen and/or progesterone (Estrogen receptor, progesterone receptor status) sensitive?" Because high levels of estrogen and progesterone occur during pregnancy, some studies indicate that any potential breast cancer cells can be stimulated during the pregnancy which means that if there is recurrent breast cancer, going through a pregnancy may worsen the health outcomes. One of the ways a woman might avoid this is to have a surrogate carry the pregnancy.

So to answer your question, breast cancer survivors can get pregnant without assistance if they have regular menses after treatment. Once they are pregnant, they can stay pregnant until term unless they are in the middle of treatment when they get pregnant. Breastfeeding is possible with lumpectomy although some of the ducts may be scarred from surgery. A woman with complete mastectomy in one breast will not be able to breastfeed from that breast. I hope this is helpful.

Dr. Esther
An oncologist would be in a better position to answer this question.
First of all, I am a diagnostic radiologist and as such, I do not do radiation treatment. That being said, the younger you are, the better chance of being able to conceive after chemotherapy. So, at 32 years old, I would say that she has an excellent chance.

Her ability to get pregnant depends on whether the chemotherapy completely wiped out her ovarian function. If she is having periods, then her ovaries are fine and she should be able to conceive. Breastfeeding will not be possible if she had a double mastectomy. She will need to discuss with her cancer doctor, her treatment goals and her pregnancy plans.
That is blessed news. Prayers to all of you. With regard to future
pregnancy, the short answer is yes. However, there are caveats and she
should have detailed conversations with her oncologist, ob/gyn and perhaps
a genetic counselor. I hope this helps.

Thank you and all the best.
Congratulations to your sister as a survivor!.
Yes she can get pregnant as long as she has completed her therapy and is several months out ideally. The therapy should have no effect on her ability to stay pregnant. As far as breastfeeding, that would depend on the amount of breast tissue she has available and would be recommended that she tries.
Please be aware that pregnancy planning should be discussed with the oncologist - the cancer doctor. After breast cancer, sometimes pregnancy needs to be avoided for a few years since the elevated hormones of pregnancy might increase the risk of the cancer coming back.

If your sister has normal regular periods after chemo, there should be no issues getting pregnant. If her periods are not returning just yet, she should be patient and consider testing of her other hormones like thyroid and adrenal to see if they were affected by the chemo and stress. Both thyroid and adrenal health can affect ovarian hormones.

Once pregnant, your sister should have no issues staying pregnant. The chemo affects the ovary but once periods start, everything is back to normal.

As far as breast feeding after mastectomy - once the breast tissue is removed, there should be no possibility of breastfeeding from the mastectomy side, but the remaining breast should allow breastfeeding.

Best of health to your sister!