Fertility preservation for women with cancer means protecting reproductive function before treatment begins. Chemotherapy and radiation work against cancer, but both carry a real risk of permanent damage to the ovaries and egg supply. The options available today, egg freezing, embryo freezing, ovarian tissue cryopreservation, and ovarian transposition, give women a genuine pathway to biological parenthood after treatment ends.

Most women aren’t aware this conversation needs to happen before their first oncology appointment. That gap costs them time they don’t have.

According to Dr. Tanuja Uchil, Obstetrician and Gynecologist in Mumbai, “Fertility preservation needs to happen before cancer treatment starts, not after. Once chemotherapy has begun, the window narrows significantly. This conversation should be part of the first oncology discussion, not something brought up weeks later.”

The right option depends on your age, diagnosis, the treatment planned, and how much time you have. Not every method suits every situation.

• Egg Freezing: The most established route for women without a partner. It requires two to six weeks of ovarian stimulation before retrieval, though newer random-start protocols can shorten this timeline. That matters when cancer treatment can’t wait long. Still the most widely used option.

• Embryo Freezing: Eggs are retrieved, fertilised using a partner’s or donor sperm, and the resulting embryos are frozen. Success rates run slightly higher than egg freezing alone, but a sperm source is needed before the process can begin.

• Ovarian Tissue Cryopreservation: A surgical option for women who can’t delay treatment at all. A portion of ovarian tissue is removed and frozen before chemotherapy starts, and it can be reimplanted after treatment. Best suited to younger women with a good ovarian reserve.

• Ovarian Transposition: For women receiving pelvic radiation specifically. The ovaries are surgically repositioned out of the radiation field to limit direct damage. But it doesn’t protect against chemotherapy-related harm, so it’s relevant only when radiation is the primary concern.

Timing and cancer type together decide which method is appropriate. Our fertility preservation team at OMA assesses both before making any recommendation.

Always before treatment starts. A few situations make this conversation especially urgent.

• Breast Cancer Under 40: The most common cancer in younger women. Chemotherapy for breast cancer carries significant ovarian risk. And because some breast cancers are hormone-sensitive, stimulation protocols often need to use tamoxifen or letrozole rather than standard FSH. Standard protocols aren’t always safe here.

• Gynaecologic Cancers Needing Surgery or Radiation: Cervical, ovarian, and uterine cancers may involve treatment that directly affects reproductive organs. Fertility-sparing surgical approaches are sometimes possible depending on cancer stage, but only if discussed early enough.

• Lymphoma and Leukaemia: Alkylating agents used in these cancers are among the most damaging to ovarian reserve. Referral to a fertility specialist should happen at the same time as oncology planning, not after it’s already in motion.

• Any Diagnosis Involving Pelvic Radiation: Radiation scatter reaches the ovaries even with shielding in place. Ovarian transposition offers the best protection and can often be performed alongside other planned surgical procedures, without adding significant time.

Because these decisions involve both oncology and fertility teams working in parallel, our onco-gynecology care at OMA is structured for exactly this kind of coordinated planning.

Dr. Tanuja Uchil holds an MD in Obstetrics and Gynaecology from Seth G S Medical College and a Diploma in Reproductive Medicine from Christian Albrechts University, Kiel, Germany. At OMA, she works alongside surgical oncologists Dr. Jay Rashmi Anam and Dr. Rajpurohit Jitesh Rajendra Singh, so fertility and cancer care are planned together from the start rather than in separate conversations.

So when the window between diagnosis and treatment is short, the team moves quickly. The goal is giving every woman a realistic option before that window closes, not a delayed referral to a fertility clinic two weeks into chemotherapy.

Call +91 72089 73301 to book your consultation.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10684029/
https://pmc.ncbi.nlm.nih.gov/articles/PMC11744204/

Disclaimer: This blog is written for educational purposes only and does not substitute for medical advice. If you have received a cancer diagnosis and are concerned about your fertility, speak to a qualified specialist before your treatment plan is finalised.