When many women hear the diagnosis “breast cancer,” a lot of the other concerns and considerations in their lives take the back burner for a time. Pursuing treatment and taking care of themselves becomes a major priority.

But if these same women are planning to have children (or more children), it’s possible that the treatments keeping them alive to be mothers can also hinder their ability to become or maintain a pregnancy.

Breast cancer patients being treated with certain hormonal therapies can experience a temporary loss of fertility. Sometimes, these treatments can make ovaries more active, but women undergoing them are advised not to become pregnant during treatment as these drugs can harm a developing baby. Once the treatments are stopped, their fertility may return, meaning it’s not impossible for them to become pregnant, but it might be more difficult.

Chemotherapy can harm fertility by damaging a woman’s eggs and/or by disrupting menstrual cycles. And other women may undergo ovarian shutdown as a treatment, either achieved with medications that cause ovaries to stop releasing eggs or with the surgical removal of ovaries. In these cases, infertility is permanent.

If you fall into one (or more) of these groups, it’s important to understand that the breast cancer treatment directed by your doctor is key to your continued health and that there are options when it comes to surviving breast cancer and protecting your fertility.

But it starts with a conversation. Be proactive and make sure you voice any concerns and wishes to your doctor and treatment team. Ask them about:

• The timing of your treatment. Would it be safe to postpone to allow for the freezing of some of your eggs or your ovarian tissue?
• The safety (for you) of fertility treatments like ovarian stimulation.
• The use of ovarian suppression drugs during your chemo.

If you do face infertility after treatment due to damage to or the shutdown of your ovaries, there are still options for pursuing motherhood.

• Egg donation
• Surrogacy
• Adoption