“The process of egg freezing is slightly different for a woman who has cancer when compared to someone who is electively preserving their fertility,” explains Pavna Brahma, M.D., a reproductive endocrinologist at Piedmont Atlanta Hospital. There are several reasons this process is unique. “One is that the timeline for a cancer patient is often a fast one.

Many times, I’m meeting somebody with a really recent diagnosis of breast cancer, which is probably the most common,” she says. This patient may need to begin chemotherapy within two to four weeks, so the egg freezing process must move quickly into stimulation and preparation of the ovaries in order to harvest the eggs prior to cancer treatment.

“A lot of breast cancers are estrogen-receptor and progesterone-receptor positive, so when we do in vitro fertilization, we make estrogen levels typically rise four to 10 times the normal endogenous body level,” she says. “When someone has cancer that would be responsive to that estrogen, we need to use extra medicines to lower one’s estrogen during the stimulation so that it is still a safe opportunity.”

Fertility specialists use Letrozole, an anti-estrogen type of drug, that helps them limit the estradiol levels but still get the same number of eggs. “Data has been shown that it doesn’t limit the number of eggs for patients, and it doesn’t appear so far to change their breast cancer prognosis,” Dr. Brahma says. Click here for more information about fertility preservation.

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