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After being diagnosed with stage IV ovarian cancer in 2012, Heeramandi actress Manisha Koirala underwent treatment in New York during 2012-13, recovered in 2014 and recently admitted to infertility, saying that “it was very difficult to suffer from ovarian cancer and not be able to become a mother”, making it important to understand the impact of cancer on fertility and whether women can become mothers even after beating the disease. Ovarian cancer is a type of cancer that develops in the small female reproductive organ – the ovaries, which are responsible for producing eggs – it can spread throughout the abdomen without causing any symptoms.
Manisha had said in an interview to NDTV, “Somewhere in my life, something was left incomplete. As you grow up, you accept your reality. There are many dreams that you know are not going to be fulfilled and you accept that. Motherhood is one of them. Having ovarian cancer and not being able to become a mother was very difficult. But I accepted that. And I said jo ho gaya so ho gaya (what’s past is past), and let me do my best with what I have got.”
A lasting impact
In an interview with HT Lifestyle, Dr Supriya Puranik, director, 9M Fertility and senior obstetrician and gynaecologist at Ankura Hospital for Women and Child in Pune, explained, “Ovarian cancer has a lasting impact on a woman’s fertility, as it involves treatments such as chemotherapy and surgery. Chemotherapy is effective in killing cancer cells, but it can also damage healthy cells in the ovaries, thereby harming fertility. Moreover, some women may also experience temporary or permanent menopause as a result of chemotherapy and may find it challenging to conceive.”
He added, “Surgeries to remove ovaries or tumours can also impact fertility and one will not be able to conceive and embrace motherhood. However, women should not panic as they have a successful chance of conceiving due to assisted reproductive technologies (ART) such as egg freezing or IVF. Egg donation or third-party reproduction is the only option for those who have already undergone surgery or chemotherapy. When it comes to communicating fertility options to women battling ovarian cancer, it will be imperative for experts to provide support, collaboration and guidance to help them make informed decisions and improve their reproductive health.”
Art as a savior?
According to the fertility expert, “Assisted Reproductive Technology (ART) is a ray of hope for women who are suffering from ovarian cancer and are struggling with infertility. One can opt for freezing or embryo preservation before starting cancer treatment to fulfill the dream of pregnancy. Using donor eggs or embryos through in vitro fertilization (IVF) is also a viable option for women with ovarian cancer. It is the need of the hour for women to consult a specialist and discuss any doubts about cancer treatment and fertility options. The specialist will examine you, take your medical history, conduct necessary tests and design a suitable ART option for you so that you can achieve a successful pregnancy.”
Dr Rohini Khera Bhatt, Consultant Obstetrician Gynecologist and Laparoscopic Surgeon, Medicover Hospitals, Navi Mumbai, shares her expertise on this, “Ovarian cancer can spread throughout the abdomen without causing any symptoms, which is why it becomes almost impossible to detect its growth, especially in the early stages. Due to the growth of cancer, there can be disruption in the production of eggs and hormones, which reduces the chances of conceiving naturally. There can be various factors that trigger ovarian cancer such as family history of ovarian cancer, endometriosis, never having conceived before. Not all women suffering from ovarian cancer have trouble with fertility or conceiving. Women who face complications while conceiving may opt for egg freezing, IVF (in vitro fertilization), IUI (intrauterine insemination),
not an impossible dream
Dr Shruti N Mane, Consultant Fertility & IVF Expert at Motherhood Fertility & IVF in Kharghar, Navi Mumbai, explains, “Ovarian cancer can have a significant impact on a woman’s fertility, with the extent of this impact depending on a number of factors, including the stage and type of cancer and the mode of treatment. In early-stage ovarian cancer, the ovaries can be surgically removed, which will directly impair a woman’s ability to become pregnant naturally. However, if only one ovary is removed, and the remaining ovary is healthy, it may still be possible for a woman to conceive and carry a pregnancy to term. In advanced-stage ovarian cancer, more extensive surgery, such as removal of both ovaries, the uterus, and surrounding lymph nodes, may be necessary.”
“This will effectively eliminate the woman’s natural ability to become pregnant. In such cases, options such as freezing eggs or embryos prior to treatment or using a surrogate may be considered for future family planning,” he explained. It is important to note that advances in cancer treatment, including targeted therapies and better surgical techniques, have increased the chances of survival for many women with ovarian cancer. With proper medical care and support, many women are able to become mothers after successfully beating the disease. However, specific fertility outcomes will depend on the individual’s situation and should be discussed with their doctor.”
Dr Nisha Pansare, Fertility Consultant at Nova IVF Fertility in Pune concludes, “Ovarian cancer can significantly impact a woman’s fertility in a number of ways. Cancer or treatments such as chemotherapy and radiation can damage or destroy the ovaries, reducing the number of viable eggs. This can make it difficult or impossible for a woman to become pregnant naturally. Additionally, the surgery required to remove ovarian tumors can also affect the ovaries and fallopian tubes, further reducing fertility. Egg freezing, also known as oocyte cryopreservation, has become an important option for women with ovarian cancer. The process involves extracting and freezing a woman’s eggs before starting cancer treatment, which can later be used for in vitro fertilization (IVF). This allows women to preserve their fertility and have the opportunity to conceive even after undergoing cancer treatment. “Egg freezing provides a valuable option for ovarian cancer patients to preserve future fertility.”
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