Helping You Overcome Fertility Hurdles
- Former Broadway actress Sarrah Strimel Bentley, 42, loves being a new mom to her adorable baby boy. Fertility was among her concerns after she was diagnosed with stage hormone receptor-positive breast cancer at 38 years old.
- Hormone-positive (HR+) and HER2-negative (HER2-) breast cancer are the most common types of breast cancer.
- Various cancer treatments, including chemotherapy and radiation, can affect both men’s and women’s fertility. Still, like Bentley, IVF is among several options cancer patients can turn to if they have hopes of parenthood.
- Before undergoing cancer treatment, patients should speak to their doctors about fertility preservation if they wish to have a family in the future.
Feuling her emotional rollercoaster was the thought a cancer diagnosis could affect her ability to have a baby — something she desperately wanted.
Read MoreView this post on InstagramFortunately, Bentley learned shortly after her diagnosis that a cancer diagnosis does not mean her dreams of parenthood were thwarted because several options exist to help preserve fertility.
Bentley spent years working on Broadway, participating in productions such as “The Producers” and “Young Frankenstein.” She also worked as a yoga instructor and founded “Damn Good Yoga.” She considers herself fit and healthy, which added to her bewilderment when she discovered she had breast cancer.
“I had no family history and was only 38, younger than the recommended age to get mammograms,” she previously told Newsweek.
She said an itch under her armpit led to her discovering a walnut-sized lump in her breast. Follow-up tests, including an ultrasound, revealed “abnormal” results. Her doctor then revealed her diagnosis.
@sarrahstrimelbentley I adore working with @bloomingdales every year to guide Pink Yoga, benefitting #thetutuproject and #bcrf #fyp #foryoupage #breastcancer #yoga #breastcancerawareness💕 #survivor #nyc #bloomingdales #breastcancerawarenessmonth #adamngoodlife #damngoodyoga ♬ original sound – Sarrah Strimel Bentley “I got the biopsy results back that, indeed, I had stage 2 invasive ductal carcinoma (breast cancer, which begins in the lining of the milk ducts), and it was like time stopped. Of course, I was terrified,” Bentley told ABC News.
“They said that test saved my life, as my cancer was extremely aggressive. If I’d have waited for the ultrasound any longer, it most likely would’ve spread,” Bentley said.
Understanding breast cancer types
Bentley says her cancer was hormone receptor (HR)-positive, HER2-negative. Hormone-positive (HR+) and HER2-negative (HER2-) breast cancer is the most common type of breast cancer, accounting for about 70% of new cases worldwide per year.
HER2 stands for human epidermal growth factor receptor 2. It’s a protein that helps breast cancer cells grow quickly.
Traditionally, the presence of HER2 has been divided into two groups, either positive or negative, leaving about 50 percent of patients somewhere in the middle. These groupings are based on how the tumors appear under a microscope when graded by the pathologist or with additional testing a pathologist may perform.
Patients with HER2-positive tumors have tumors that show HER2 over-expression, while patients with HER2-negative tumors show minimal or no expression.
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While wrapping her mind around her cancer diagnosis, Bentley’s doctor prompted another conversation deeply personal to her. She asked about fertility and candidly discussed the impact cancer treatment can have on fertility.Cancer treatment & fertility
At the time, Bentley said that she had “no idea that when you have breast cancer, your fertility would be affected.”
Some types of chemotherapy can destroy eggs in your ovaries. This can make it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the drug type and age since your egg supply decreases with age.
“The risk is greater the older you are,” reproductive endocrinologist Dr. Jaime Knopman told SurvivorNet.
Noting she had always dreamed of becoming a mom, she was eager to learn what she could do to preserve her fertility before starting treatment.
Bentley and her boyfriend underwent two rounds of in vitro fertilization (IVF) that produced a single embryo.
After taking steps to preserve her fertility, Bentley began breast cancer treatment.
“I underwent eight rounds of chemotherapy, 28 rounds of radiation, two breast reconstructive surgeries, and an ovariectomy where they removed my ovaries,” Bentley explained.
Breast reconstruction surgery is an option for women after going through a mastectomy for breast cancer treatment. The reconstruction process can happen at the time of the surgery to remove the breast or later on. Getting reconstruction surgery is a very personal choice for women to make, and many don’t go through reconstruction. However, for the women who do, they’ve said that it’s a way for them to feel more like themselves after going through the difficult experience of a breast cancer battle.
Today, Bentley is all smiles and grateful because she says she is “cancer-free” and her lifelong dream has come true. Her son was born via surrogate in December 2023.
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“I swear he looks, not just at me, but into my soul. Like he’s known me for lifetimes,” Bentley described in an Instagram post showing her holding her newborn.
“My healer wasn’t all of the advanced treatments, surgeries, and therapies (although they saved my life, and I am eternally grateful for them) …my true healer is my tiny miracle and was all along,” she added.
Bentley also spends her time advocating for women diagnosed with breast cancer and facing fertility challenges through a non-profit.
Helping Patients With Fertility Resources
Turning to IVF as an option for cancer patients
Cancer treatments like chemotherapy can damage sperm in men, and hormone therapy can decrease sperm production, according to the National Cancer Institute. Radiation treatment can also lower sperm count and testosterone levels, impacting fertility. Just as cancer treatment can impact men’s fertility, women may also be affected.
Radiation to the pelvis can also destroy eggs. It can damage the uterus, too. Surgery to your ovaries or uterus can hurt fertility as well.
WATCH: Fertility after Cancer
Meanwhile, endocrine or hormone therapy may block or suppress essential fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment.
If you have a treatment that includes infertility as a possible side effect, you should discuss your options for fertility preservation before starting treatment.
Research shows that women who have fertility preserved before breast cancer treatment are more than twice as likely to give birth after treatment than those who don’t take fertility-preserving measures.
Most women preserve their fertility before cancer treatment by freezing their eggs or embryos.
After you finish your cancer treatment, a doctor specializing in reproductive medicine can implant one or more embryos in your uterus or the uterus of a surrogate with the hope that it will result in pregnancy.
If you freeze eggs only before treatment, a fertility specialist can use sperm and eggs to create embryos in vitro and transfer them to your uterus.
When freezing eggs or embryos is not an option, doctors may try these approaches:
- Ovarian tissue freezing is an experimental approach for girls who haven’t yet reached puberty and don’t have mature eggs or for women who must begin treatment immediately and don’t have time to harvest eggs.
- Ovarian suppression prevents the eggs from maturing so they cannot be damaged during treatment.
- For women getting radiation to the pelvis, Ovarian transposition moves the ovaries out of the line of treatment.
In addition to preserving eggs or embryos, positive research has shown that women with early-stage hormone-receptor (HR) positive breast cancer were able to safely pause endocrine therapy (ET) to try to get pregnant, and they did not have worse short-term recurrence rates than people who did not stop endocrine therapy.
Questions for your doctor
If you’re wondering how your cancer treatment may affect your fertility and what options are available to you, consider asking your doctor these questions, according to the National Cancer Institute:
- Could my treatment lead to infertility?
- Are there other recommended cancer treatments that might not cause fertility problems?
- Which fertility preservation options would you advise for me?
- What fertility preservation options are available at this hospital? At a fertility clinic?
- Would you recommend a fertility specialist (such as a reproductive endocrinologist) I could talk with to learn more?
- What are the chances that my fertility will return after treatment?
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