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Post Cancer: Pregnancy, Adoption, and Infertility

Preparing to parent after cancer treatment can be both an exciting and a terrifying journey depending on what your experience with cancer was and what your current parenting options are.  A recent podcast entitled “Adoption or Infertility Treatment after Cancer,” broadcast by Creating a Family, a nonprofit providing education and resources for infertility and adoption, tackled this issue with a panel of four experts, including Irene Su, M.D., MSCE, Assistant Professor of Reproductive Medicine at University of California in San Diego (UCSD) and member of the Oncofertility Consortium. The panel spoke in depth about issues surrounding pregnancy, adoption, infertility and recurrence.

One topic that particularly stuck out in my mind was the discussion as to whether or not attempting to become pregnant after treatment increased a cancer survivor’s chance of recurrence, specifically with hormone related cancers such as breast cancer.  According to Dr. Su, “most studies show that there is not an increased risk for recurrence; however, the majority of oncologists would suggest that a patient wait until they are out of the recurrence stage before attempting to get pregnant.” Beyond the clinical aspect of this issue, is the personal. The fear that many women have of recurrence if they were to get pregnant, regardless of what science suggests. After having been through such a traumatic and life changing experience, not every woman is emotionally prepared to invest in a pregnancy. Those that do make that decision should consult with both a high-risk obstetrician and a reproductive endocrinologist to insure that they are in the care of health professionals that understand the specific issues relevant to cancer survivors.

An alternative for cancer survivors interested in having children, but not wanting to attempt pregnancy or being left infertile as a result of treatment, is adoption.  Adoption can sometimes be a little more complicated for cancer survivors because not all adoption agencies allow cancer survivors to adopt for fear that the child will lose the adoptive parent to the disease or that the parenting experience will not be optimal due to the possibility of recurrence. Other adoption agencies have specific guidelines for how long an individual has to be cancer free before they are eligible to adopt. For example, in Korea there is a five year wait and in China, the waiting period is 10 years without recurrence before you are eligible to adopt. Many domestic adoption agencies have a shorter wait time, but ultimately it is determined on a case by case basis. In 2010, members of the Oncofertility Consortium performed an analysis of domestic and international adoption agencies as they pertained to cancer survivors and then compiled a list of cancer-friendly adoption agencies that survivors could refer to when researching their options.

As a result of the complicated dynamics involved with parenting post cancer, it’s important for newly diagnosed cancer patients to know their options in terms of fertility preservation before beginning treatment. According to Dr. Su, “there are no exact studies about infertility and cancer, just a strong idea about likelihood,” so it’s important to be well-informed about fertility preservation and your specific options. There are many different roads to parenthood, but the more informed you are, the better off you’ll be. To listen to this podcast, go to http://www.creatingafamily.org/radioshow.html.

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