Herceptin and Fertility New Member

[River25]

Hello everyone. I am so glad I found this forum. I am new to this group. I have been learning quite a bit from everyone's posts.

I am 37 years old. Diagnosed with BC (HER2+) in July 2007, just three weeks before my wedding. I finished chemo a month ago and will begin radiation next week. My last MRI and mammo were clean! Therefore a mastectomy was not warranted. Here is my question...

I began Herceptin in November and will continue for one year. My husband and I want to have children. While I was on chemo, I did take Lupron once a month. This is an injection that shuts down an woman's ovaries in order to protect them from the chemo. I am wondering, however, if anyone knows the effects Herceptin has on a woman's fertility. Of course I am concerned. I look forward to hearing people's responses. Thank you! River

[R.B.]

I read a reference to a trial using lupron to protect fertility about three years ago. From a rather vague recollection it showed promising results.

I would guess you have researched yourself. My hazy recollection of the small amount I have seen on the subject suggests that likely fertility is not affected but they don't really know.

Here are two links to searches that make reference to fertility and herceptin.

http://www.wirral.nhs.uk/uploads/doc.../Herceptin.pdf

http://www.gene.com/gene/products/in...tin/insert.jsp

"A fertility study conducted in female cynomolgus monkeys at doses up to 25 times the weekly recommended human dose of 2 mg/kg trastuzumab has revealed no evidence of impaired fertility, as measured by menstrual cycle duration and female sex hormone levels. Studies to evaluate the effects of trastuzumab on male fertility have not been conducted."

[Mary Jo]

Hello.....
I can't offer any advice about fertility and herceptin but I wanted to welcome you to the her2 support board. Although I'm sorry you have to have breast cancer I'm happy you found us.

God Bless you,

Mary Jo

[River25]

Thank you so much! That is very sweet of you, R

[kcherub]

Hey, there!

Welcome, and I am sorry you have need to be here!

I am only 35, so fertility issues have been a priority for me. From what I can gather, and this is just from memory, is that Herceptin should not impair your future fertility (based upon what they know now). You should not attempt to get pregnant while you are on it, and for at least six (6) months afterwards.

Did your radiation oncologist tell you wait 18-24 months after treatment before trying to become pregnant? It was in my paperwork, but I have frozen embryos, so they said it wasn't as much of a concern for me. Not to give you anything else to obsess over! Cause I am sure you have enough already!

Take care,

[Lani]

fertility ie, fertility WHILE herceptin is still being given. As I recall, It is not recommended to get pregnant while on herceptin as her2 neu is important in the migration of the neural crest (which becomes the brain and spinal cord among other things) and respiratory and GI tract development in the embryo --although there are cases where normal children were born despite herceptin treatment (probably has to do with the timing of when the embryo was exposed to herceptin)

I cannot recall reading anything about difficulties with fertility FOLLOWING completion of herceptin treatment that were specific for herceptin, although it is SO hard to dissect out what effects are due to chemo vs hormonal manipulation vs herceptin that I doubt this information will be available for a long time (if ever, with certainty at least)

Theoretically(and this is TRULY A GUESS and not from someone qualified to know, just from my readings) based on the way herceptin is assumed to work (and it is assumed to work in multiple ways) the effect of herceptin on the immune system, ability of cells to migrate, etc should not be expected to last after the last herceptin antibodies are no longer in your system. That is usually assumed to be six months after you stop herceptin. But as (at least in metastatic breast cancer patients) there has been shown to be a 40% difference(variability) in the rate of clearance of herceptin out of the system between the fastest and slowest "metabolizers" of herceptin, that figure may not hold for you.

It seems the first two years after surgery are the most worrisome for early recurrence (not a guarantee and there is no evidence yet that the same picture of recurrence will be true for those for whom herceptin is effective)...I suppose you must consider whether you would want to be pregnant during that time or shortly thereafter anyway, as you would not be able to breast feed if receiving treatment, may not have the energy to run after a toddler, etc let alone the long term prospects ...

I know you are newly married and feel the clock is ticking but...I am sure there are those on this board who can provide additional input on this matter.

If you will clarify if you are talking about fertility problems more than 6 months after stopping herceptin, I will try to do a literature search. If you are asking about trying to get pregnant while on herceptin I will send you a different set of articles. Those reports are of those who INADVERTANTLY got pregnant while on herceptin or had to be treated with herceptin when advanced/metastatic bc occured after already pregnant as I recall.

Hope this helped!

[Audrey]

Welcome, River! I just wanted to let you know that there is a woman named Stepanie Spielman (wife of football player Chris Spielman) here in Ohio who got pregnant while on Herceptin (inadvertantly) but her daughter turned out totally fine (they named her Audrey, which is why I remember this so well) and she (the mom) is doing well now, too. Not that I recommend getting pregnant while on Herceptin, but just so you know it has been done before with a good outcome. You can check out Stephanie's story on her website, which I can't remember the name of, but try googling her or her husband.

[kcherub]

I have a question about using Lupron during chemo to "protect" the ovaries. I took Lupron during my IVF cycle in 1999, and my understanding is that yes--it does shut down the ovaries from actually ovulating.

My "but" is that we already have all of the undeveloped eggs we will ever have in our lifetimes stored in the ovaries. As fertility after treatment for cancer is one of my big concerns, how can Lupron really protect the undeveloped eggs stored in the ovaries?

I am going to bring this up with my RE, just to know. Even if doesn't apply to me, I like to know!

Take care,

[Lani]

One page.
1:
Related Articles, LinksPritchard KI.

Adjuvant therapy of the very young woman.
Breast. 2007 Dec;16 Suppl 2:S136-46. Epub 2007 Sep 4.
PMID: 17766115 [PubMed - in process]
2:
Related Articles, LinksMunster PN.

Improving breast cancer care.
Cancer Control. 2002 Nov-Dec;9(6):455-6. No abstract available.
PMID: 12514562 [PubMed - indexed for MEDLINE]
3:
Related Articles, LinksKuter I.

Breast cancer.
Oncologist. 2001;6(4):338-46. Review.
PMID: 11524552 [PubMed - indexed for MEDLINE]

[LAURIE]

I can sooooo relate. I still want to have kids and finished herceptin in DEC. you can send me a personal message if you want to share more.