What is infertility in females?

Infertility in females is a condition where a woman is unable to get pregnant and give birth. Many cancer treatments (chemotherapy, radiation therapy) can cause infertility in females. Your doctor will explain to you whether or not cancer treatment may lower fertility or cause infertility.

How bad is infertility in females?

Mild: The symptoms include nausea, back pain, acne, thinning of hair, and irregular periods. In most of the cases, infertility is reversible with appropriate treatment.

Moderate to Severe: You may have chronic pelvic pain, weight gain, abdominal cramps, painful periods or absence of periods, and fatigue (tiredness). Infertility may or may not be reversible. See your doctor if you are having difficulty conceiving after 12 months of trying to get pregnant. Also, consult a fertility specialist if you had cancer treatment, such as chemotherapy and radiotherapy.

How to manage infertility in females?

Keep track of your symptoms using Ankr (myAnkr web portal or the Ankr app). It will help you describe the discomfort to your doctor or nurse.

• Egg freezing is a procedure in which the surgeon removes the eggs from the ovary. Later the frozen eggs are thawed, fertilized with sperm in the lab to form embryos. It is placed in a woman’s uterus. 
• Embryo freezing involves removing of eggs from the ovary. They are fertilized with sperm in the lab to form embryos and frozen for future use.
• Ovarian shielding involves placing a protective cover over the ovaries and other parts of the reproductive system, to shield them from scatter radiation.
• Ovarian tissue freezing is for young girls who haven’t gone through puberty and don’t have mature eggs. It involves surgically removing part or all of an ovary and then freezing the ovarian tissue, which contains eggs.
• Ovarian transposition is a surgery to move the ovaries away from the part of the body receiving radiation.
• Radical trachelectomy is a surgery to treat women with early-stage cervical cancer who would like to have children. The operation removes the cervix, nearby lymph nodes, and the upper part of the vagina. The surgeon attaches the uterus to the remaining part of the vagina, with a special band that serves as the cervix.

When to see a doctor?

Any female experiencing signs of infertility and who has been trying to conceive for more than a year (or 6 months if older than 35 years of age) should consult a doctor for a thorough diagnosis.

Sometimes there may be simple ways to make lifestyle adjustments to improve fertility, while other underlying causes may require treatment.

What causes infertility in females? 

Cancer treatments may harm reproductive organs and glands.

• Chemotherapy can affect the ovaries, causing them to stop releasing eggs and estrogen. Sometimes it is temporary. Your menstrual periods and fertility can return after treatment. Other times, damage is permanent and fertility doesn’t return. You may have hot flashes, night sweats, irritability, vaginal dryness, and irregular or no menstrual periods. Chemotherapy can also lower the number of healthy eggs in the ovaries.
• Radiation therapy to or near the abdomen, pelvis, or spine can harm nearby reproductive organs. Radiation therapy to the brain can also harm the pituitary gland. The gland is important because it sends signals to the ovaries to make estrogen.
• Surgery for cancers of the reproductive system and for cancers in the pelvis region can harm nearby reproductive tissues which can affect your fertility.
• Hormone therapy can disrupt the menstrual cycle, which may affect your fertility. Side effects depend on the specific hormones used and may include hot flashes, night sweats, and vaginal dryness.
• Bone marrow transplants and other stem cell transplants involve high doses of chemotherapy and/or radiation. These treatments can damage the ovaries and may cause infertility.
• Other treatments (immunotherapy and targeted cancer therapy) may affect your fertility.