Protecting Your Fertility When You Have Breast Cancer

Learn about a treatment that can protect fertility when treating breast cancer.

Medically reviewed in December 2020

When starting treatment for breast cancer, a woman has to face a lot of scary possibilities. There’s the chance she’ll lose her hair or her breasts, or that the cancer will come back. For young women, there’s another less obvious worry: the possibility of not being able to have a baby in the future. But one promising treatment could dramatically lower the chances of losing fertility in certain women with breast cancer.

A multi-center, randomized trial looked at 135 women under the age of 50 with hormone receptor-negative breast cancer. Researchers found that women treated with the hormonal agent goserelin in addition to chemotherapy were about two-thirds less likely to suffer premature ovarian failure than those who received chemotherapy only. Women treated with goserelin were also about twice as likely to get pregnant and give birth compared to the chemo-only patients. This is exciting news because it gives additional evidence that there’s something women with breast cancer (and other types of cancer) can do to preserve their fertility. The study was presented at the 2014 American Society of Clinical Oncology annual meeting.

How goserelin works
In addition to attacking cancer cells, chemo can destroy the eggs in a woman’s ovaries, often putting younger women into early menopause. That leads to infertility, along with increasing the risk of osteoporosis, heart disease and other problems. The drug goserelin, which is given in monthly injections at a doctor’s office, temporarily puts the ovaries in a “resting” state. This essentially means the drug shuts down the ovaries’ activity, making them less vulnerable to chemotherapy. Other breast cancer treatments, such as radiation and surgery, generally don’t affect a woman’s fertility, unless the ovaries are removed.

Know your fertility options
Goserelin has only been shown to work in hormone receptor-negative breast cancer, which accounts for about 10-15% of cases. Even then, experts say goserelin should be used only with other methods to preserve fertility. If you’ve been diagnosed with breast cancer and want to have a child in the future, here are some other options you can consider:

  • Embryo cryopreservation. This is when eggs are harvested from the ovaries, fertilized through in vitro fertilization (IVF), and implanted later when a woman is ready to get pregnant. While this method has the highest chance of success for women, it’s expensive and the sperm must be made available immediately to fertilize the egg.
  • Egg freezing. Similar to embryo freezing, unfertilized eggs are frozen and then stored.
  • Ovarian cryopreservation. This new, experimental option involves removing, freezing and storing all or part of an ovary. The tissue then can be placed back in the body later. In some cases, researchers have even implanted it in the arm. 

Regardless of the method you choose, many doctors advise cancer survivors wait two years before attempting to get pregnant. That’s because the risk of relapse is greatest in the first two years. But every woman’s risk is different, so work with your doctor if you’re planning to conceive.

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