Pregnancy after oncology

Pregnancy planning after oncology

Unfortunately, oncological diseases are getting younger every year. Therefore, it is not surprising that many women are acutely faced with the question of the possibility of experiencing the joy of motherhood after suffering from cancer.

Despite the fact that specific drugs and techniques are used in the treatment of malignant processes that have a negative impact on the body as a whole and reproductive function in particular, it is possible to plan pregnancy after oncology.

Modern medical technologies make it possible to treat malignant pathology while preserving a woman's reproductive functions. Innovative medicines are used, a wide range of organ-sparing operations are performed, new methods of radiation therapy are used, in which radiation exposure has a targeted effect, and the uterus and ovaries are not exposed to radiation.

The discovery of an oncological process is always a shock for a woman, so she usually misses the "right" moment to conceive and bear a child. And it is the doctor who takes the initiative to discuss with the patient the possibility of preserving reproductive function for subsequent pregnancy.

Methods of preserving reproductive function in oncology

To preserve the fertility of a woman with oncological pathology, modern medicine offers various methods:

• Organ–sparing operations - radical trachelectomy, conization of the cervix, surgical treatment of ovarian tumors (borderline).
• Cryopreservation of oocytes/embryos.
• Radiation therapy of a targeted nature with modulated intensity (IMRT).

After achieving stable remission, patients can return to the issue of having a child on their own or using ART techniques.

When can I plan pregnancy after cancer

Pregnancy planning after cancer should take place with the participation of an oncogynecologist or oncologist and gynecologist to determine the safest period and method of conception.

It is usually recommended to plan pregnancy no earlier than 2 years after recovery, during remission, provided there is no recurrence of the disease.

There are cases when pregnancy occurs unplanned, earlier than the recommended time. Even under such conditions, there are no direct indications for termination of pregnancy. However, such patients are at high risk, and they need stricter medical supervision.

Pregnancy itself is not a provoking factor in the development of cancer, including those that were once suffered. Therefore, in the vast majority of cases, pregnancy is completely safe during remission. The exception is gestational trophoblastic disease. This is a special type of aggressive cancer that develops during or after a uterine or ectopic pregnancy.

How to start pregnancy planning after cancer

Pregnancy planning in patients with a history of cancer involves a comprehensive examination. It is conducted in strict accordance with order 572. The research methods that a woman needs to undergo depend on the type of cancer. Usually, the diagnosis includes:

• Tests for cancer markers.
• Cytological smear.
• Colposcopy.
• Control biopsy.
• Ultrasound, etc.

After histological confirmation of stable remission, a woman can plan pregnancy. If you have not been able to get pregnant on your own for 6 months, it is recommended to consult a reproductive specialist.

Features of pregnancy management after oncology

All therapeutic and preventive measures are aimed at eliminating adverse outcomes and risks.:

• Spontaneous abortion.
• Premature birth.
• Fetal development delays, etc.

There are no significant differences in pregnancy management in this case. The only difference is that a woman needs to undergo a series of additional examinations periodically.

For example, if the patient has a history of ovarian cancer, it is necessary to take an analysis for the cancer marker CA 125 every 3 months. In this case, an indicator of up to 70 u/ml with a normal value of 35 u/ml is safe for the patient and the baby. However, if the indicator goes beyond 70, serious risks arise.  
If, after the development of malignant or borderline ovarian tumors, a pregnant woman develops formations in the projection of the ovaries, it is necessary to undergo an MRI of the pelvis. Such a study does not cause any harm to either the expectant mother or the child. A crucial point in managing pregnancy after cervical cancer is systematic monitoring of the condition of the cervical stump and regular vaginal sanitation to avoid the penetration of an ascending infection. Each trimester, a smear test is performed for oncocytology. If there are any changes, colposcopy should be performed. And, of course, all patients who have had cancer are shown an oncologist's consultation once a trimester.

Advantages of contacting the EMC

• Specialists with extensive work experience, including in the best clinics in Europe and the USA.
• The most modern and effective methods of diagnosis and treatment
• The choice of pregnancy management tactics in patients with cancer or after cancer is carried out in interdisciplinary consultations with the involvement of all necessary specialists: oncologist, gynecologist, morphologist, radiotherapist, etc.