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Birth control is essential healthcare, allowing you to prevent pregnancy and take charge of your reproductive health. There are many contraceptive methods to choose from. Learning more about the available options can help you, and in some cases, your partner, make the best decisions for your needs and reproductive goals.

Choosing the Right Birth Control for You | Alto Pharmacy

Read on for an overview of some common birth control methods. Our list focuses on hormonal birth control, which contain synthetic versions of estrogen and progesterone. These two hormones play a significant role in reproduction.

There are other options for contraception that must be used every time you have sex, including condoms and diaphragms. When used correctly, condoms and diaphragms are 98% and 88% effective at preventing pregnancy, respectively.

Permanent birth control is also available in the form of surgical procedures (tubal ligation for women and a vasectomy for men). These procedures must be performed by a healthcare provider. Discuss your options for contraception with your provider.

In addition, there are two options for oral emergency contraception to be taken after unprotected sex: levonorgestrel (Plan B®, Mirena®, Kyleena®) and ulipristal (Ella®). Levonorgestrel is sometimes available without a prescription. Ulipristal is prescription-only.

Like all forms of hormonal birth control, the pill stops ovulation, which is the release of a mature egg from the ovaries during each menstrual cycle. The hormones also thicken cervical mucus, an additional layer of pregnancy prevention that keeps sperm from reaching an egg, should one be released.

There are two types of birth control pills:

Combination pills, or combined oral contraceptives (COCs), contain both estrogen and progestin. (Progestin is a synthetic form of progesterone.) COCs are the more common of the two types.

Progestin-only pills (POPs) contain only progestin.

In both cases, the pills come in a pack and you take one every day.

Many individuals choose the pill for its affordability and effectiveness. However, it must be taken on time every day in order to prevent pregnancy. You may find it helpful to combine taking your birth control with another daily habit such as brushing your teeth, or to set a reminder on your phone. The Alto app has medication management reminders to help you continue with your treatment.

While the pill is 91% effective at preventing pregnancy when taken as prescribed, it does not offer protection against sexually transmitted infections (STIs). If you have an STI or are unsure about a sexual partner’s health history, use condoms every time you have sex to protect your health and your partner’s.

The birth control ring, also referred to as the vaginal ring, consists of a small, flexible ring worn inside of your vagina. It releases hormones, which are absorbed through the vaginal lining, for ongoing pregnancy prevention. Like birth control pills, these hormones prevent ovulation and thicken cervical mucus.

There are two types of birth control rings. NuvaRing® lasts for up to five weeks. It is worn continuously and typically replaced about once a month. It may also be used to skip your period.

An Annovera® ring lasts for a year. You wear it in your vagina for 21 days, take it out for seven days, and then put it back in your vagina to restart the cycle.

A vaginal ring must be used correctly to offer full benefits. That includes replacing it when needed and, in the case of an Annovera ring, taking it out and putting it back in on time. To stay on schedule, set reminders or alarms on your phone, or keep track on a calendar. You can also check out Planned Parenthood’s free birth control reminder app, Spot On.

The birth control ring is prescription-only. It does not offer protection against STIs.

The transdermal contraceptive patch releases estrogen and progestin through the skin and into your body to prevent pregnancy. There are two branded options available in the U.S.: Xulane® and Twirla®. Both patches may be worn on your belly, butt, or back. The Xulane patch can also be worn on your upper arm.

The birth control patch is worn for a total of 21 days. You will need to replace the patch during that time, wearing a new patch each week for three weeks. During the fourth week, you will not wear a patch so that menstrual bleeding may occur. The cycle then restarts.

A patch must be used correctly and on schedule to offer effective pregnancy prevention. Set reminders or alarms on your phone, keep track on a calendar, or use a birth control reminder app.

The birth control patch is prescription-only. It does not offer protection against STIs.

The birth control shot, also referred to as the depo shot or Depo-Provera®, is an injection administered about every three months. It contains progestin and works similarly as the above forms of hormonal birth control to prevent pregnancy.

Many individuals choose the shot for the convenience of the injection schedule and privacy. In order to experience the benefits of the birth control shot, you must stay on track and get a new shot every 12-13 weeks. In most cases, a doctor or nurse will give you the shot. In some cases, you may be able to get a supply of shots from a health center to self-administer.

Use a birth control reminder app or a calendar to stay on track with your injections.

Long-term use of the Depo-Provera shot may increase an individual’s risk for significant and potentially irreversible bone mineral loss. Additionally, it has been associated with an increased risk of breast cancer and is not recommended for those with a known or suspected breast malignancy.

There are two types of longer-term birth control: intrauterine devices (IUDs) and birth control implants. Both methods release hormones into your body to prevent pregnancy.

The implant (Nexplanon®) is a tiny, thin rod implanted into your arm that offers pregnancy prevention for up to five years. It must be implanted in a doctor’s office. If your family planning goals change, a doctor can easily remove the implant before it expires.

The IUD is a small device implanted into your uterus that prevents pregnancy. There are different types of IUDs that offer protection for varying amounts of time.

Hormonal IUDs release progestin to prevent pregnancy. There are four FDA-approved hormonal IUDs in the U.S.:

Paragard® is a copper IUD that does not contain hormones. It prevents pregnancy for up to 12 years.

An IUD must be implanted by a healthcare professional. It is reversible and can be easily removed.

There are many factors to consider when choosing a birth control method. While many individuals find these forms of longer-term birth control more convenient, they are typically more expensive than other forms of contraception.

Timing is essential with many forms of hormonal birth control. We make it easy to stick to the schedule, with free same-day delivery and medication management reminders in the app. In addition, our pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to answer any questions you may have.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

With many variables involved in an individual’s fertility, learning more about your reproductive health can help you manage expectations about your body’s response to fertility treatment. The anti-mullerian hormone (AMH) test, which measures your body’s levels of a hormone associated with ovarian reserve, is one potential source of information for those experiencing infertility.

AMH Testing in Fertility Treatment

While the AMH test can reveal certain factors related to your reproductive health, it is not relevant to all aspects of fertility, or all types of fertility issues. Here’s more about the AMH test, including what it can and can’t tell you.

Anti-mullerian hormone is a hormone that affects how a baby’s reproductive organs develop while in the womb. Male babies have higher levels of AMH than female babies.

AMH is also related to a woman’s ovarian reserve. Cells inside the ovarian follicles — fluid-filled sacs that release an egg during ovulation — produce AMH. An individual's levels of AMH correspond to their egg count, with higher levels of the hormone typically indicating a higher ovarian reserve.

Unlike many other hormones related to reproductive health, AMH levels remain steady throughout an individual’s menstrual cycle. This means that you can have your AMH levels measured at any time, unlike some other fertility-related blood tests.

An AMH test is a blood test that measures your levels of AMH, revealing the approximate number of eggs in your ovarian reserve that may be used for ovulation. It provides a snapshot into one aspect of your fertility, rather than a precise look at the whole picture.

The AMH test consists of a simple blood draw. It typically takes about a week for test results to arrive. There are at-home AMH tests available, however, it is important to discuss the results with a healthcare provider.

Below are general ranges of AMH levels, measured in nanograms per milliliter. Your provider can give you a clearer sense of what your AMH levels indicate.

An AMH test is an indication of the number of eggs remaining in your ovarian reserve. This is particularly relevant to in vitro fertilization (IVF), since one goal of IVF is to retrieve as many mature eggs for fertilization as possible. Your AMH test results may also inform your individual medication protocol for IVF, as they can help your provider anticipate your body’s response to ovarian stimulation medication.

The AMH test can also indicate the pace at which your ovaries are aging.

While AMH levels are helpful for determining egg quantity, they do not reveal anything about the quality of your eggs. Egg quantity factors into IVF success rates — the more eggs retrieved, the higher your chances are of producing multiple healthy embryos that may be placed into the uterus — but quality is also extremely important. It is possible to have a low ovarian reserve but a high percentage of viable eggs, in which case a successful IVF cycle would be more likely.

It is also possible to experience infertility despite having normal AMH levels. Other factors that may affect your ability to conceive include your age, lifestyle habits, ovulation disorders, uterine abnormalities, and endometriosis, among others. Sperm count and mobility also factor into a couple’s fertility. There are many diagnostic tests a reproductive specialist may use to evaluate your remaining egg supply and recommend the best treatment plan.

Read Infertility, Explained for a more comprehensive overview of common fertility issues.

A fertility pharmacy partner you can rely on

At Alto, we’re here for you at every step of your fertility journey. We offer free same-day delivery of your medications, with discreet packaging, fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists, and support with insurance and savings opportunities.

To learn more about how Alto can support your fertility treatment, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

Polycystic ovary syndrome (PCOS) is a condition that affects women of reproductive age and is characterized by a hormone imbalance. It can impact many areas of a woman’s health, including menstrual cycles, fertility, insulin levels, and risk of cardiovascular disease.

How Polycystic Ovary Syndrome (PCOS) Affects Fertility

Symptoms of PCOS can be treated through a combination of medications and lifestyle changes. Here’s what to know about the condition’s causes, symptoms, and treatment options.

Polycystic ovary syndrome has three defining symptoms: high levels of male hormones, irregular menstrual cycles, and the development of cysts in the ovaries. These features overlap.

Many women with PCOS have higher levels of androgen hormones, which are responsible for the development of certain male characteristics. For those with PCOS, overproduction of androgens leads to irregular menstrual cycles, hair loss, extra growth of hair on the face and body, and acne.

The cysts that develop in the ovaries are small follicles containing an immature egg. Since these eggs do not reach maturity, ovulation — the release of a mature egg from the ovaries — does not occur. The absence of ovulation leads to further imbalance of hormones, as progesterone decreases.

PCOS is the leading cause of female infertility.

Polycystic ovary syndrome can develop at any age after puberty. It is estimated that 5-10% of women between the ages of 15-44 have the condition.

The specific causes of PCOS have not been identified, but the medical community believes that condition is the result of several intersecting factors: insulin resistance, higher levels of androgens, higher levels of inflammation, and an irregular menstrual cycle.

Some evidence suggests that PCOS may have a genetic component. You may have a higher risk of developing PCOS if you have a mother, sister, or aunt with the condition. Obesity is also a risk factor.

Common symptoms of polycystic ovary syndrome include:

Irregular, absent, or abnormally short (i.e., less than 21 days) menstrual periods

Excess hair on the face, chin, chest, abdomen, or upper thighs, also referred to as hirsutism

Weight gain or difficulty maintaining a healthy weight

Patches of darkened skin, particularly on the neck, in the groin, and beneath the breasts

Small flaps of excess skin near the neck or armpits, sometimes referred to as skin tags

Infertility, defined as the inability to get pregnant after twelve months or more of unprotected sex

The hormone imbalances that characterize PCOS can affect many areas of a woman’s health, including the following.

Infertility is a common symptom of PCOS, as hormone levels interfere with ovulation, an important step in reproduction. However, PCOS is a highly treatable cause of infertility. Many individuals and couples affected by PCOS do become pregnant after fertility treatment.

During pregnancy, women with PCOS may face a greater risk for miscarriage, high blood pressure, and gestational diabetes. They are also more likely to deliver prematurely. If you have PCOS, you can set yourself up for a healthy pregnancy by maintaining a healthy weight and blood sugar levels before trying to conceive and during pregnancy.

Insulin is a hormone naturally produced in the pancreas. It helps convert sugar, or glucose, into energy. Type 2 diabetes occurs when blood sugar levels rise due to issues with the body’s production or use of insulin. Since insulin resistance is often a symptom of PCOS, many individuals with the condition have a greater risk for type 2 diabetes.

Individuals with PCOS are also more likely to develop metabolic syndrome, a group of conditions associated with a higher risk for diabetes and heart disease, including:

Abnormal cholesterol or triglyceride levels

Endometrial hyperplasia, a condition in which the lining of the uterus becomes too thick, is also associated with PCOS. It can increase a woman’s risk for endometrial cancer.

The process for diagnosing PCOS includes a conversation about your health history, a physical exam, and several tests that can rule out other causes of PCOS symptoms.

During the physical exam, a healthcare provider typically measures blood pressure, body mass index (BMI), and waist size. They will also check your skin for extra hair, acne, or discoloration.

Your doctor will likely conduct a pelvic exam to check for signs of high androgen levels and abnormalities with your ovaries. Then, a pelvic ultrasound, or sonogram, will check the ovaries for cysts and scan the uterine lining.

Blood tests may be used to measure levels of androgens as well as hormones linked to other health conditions with similar symptoms as PCOS. You may also be tested for high cholesterol and diabetes.

If other health conditions have been ruled out, you must have at least two of the following symptoms to be diagnosed with PCOS:

Irregular, absent, or abnormally short menstrual periods

Signs of high androgen levels such as hirsutism, acne, or thinning of hair on the scalp

PCOS and related medical conditions can be managed through a variety of treatments including medications and lifestyle changes. Treatment is tailored to an individual’s health history, PCOS symptoms, and reproductive goals. Here’s how different treatment options target various symptoms of PCOS.

Hormonal birth control, which may contain both estrogen and progestin, is often used to regulate a woman’s menstrual cycle. It can also reduce hirsutism and acne and lower the risk of endometrial cancer. Many women who do not have plans to get pregnant use hormonal birth control as a long-term treatment for PCOS.

Metformin, an oral medication most commonly used to treat type 2 diabetes, is sometimes used off-label to treat PCOS. It improves the body’s response to insulin and can lower blood sugar and androgen levels. In some cases, it may be effective at restoring ovulation, though it typically does not treat hirsutism or acne.

Anti-androgen medications such as spironolactone (CaroSpir® and Aldactone®) block the effects of androgens and treat hirsutism. They are often used in combination with birth control and should not be used during pregnancy or when trying to conceive.

Maintaining a healthy weight can help regulate menstrual cycles. It may also improve insulin levels and treat excess hair growth and acne. Additionally, following a heart-healthy diet and staying physically active is especially important for those with PCOS.

In many cases, metformin or lifestyle changes can help address ovulation issues associated with PCOS. There are additional treatments that restore ovulation in women with PCOS, including oral medications used to treat infertility such as Clomid® and Femara® and injectable fertility medications including gonadotropins.

A procedure called laparoscopic ovarian drilling is a fertility treatment typically reserved for cases when medication is not effective.

PCOS treatment looks different for each individual, and our team has the expertise to support your personal health journey. Whether you are getting started with hormonal birth control, metformin, or fertility treatment, we’re here to simplify medication management and keep you supported.

We offer free, same-day delivery seven days a week, with temperature controlled packaging that ensures fertility medications always arrive in the right condition. And we’ll work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible.

About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, Explained

About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, defined as the inability to get pregnant after twelve months or more of unprotected sex, is a health condition that affects both men and women. Approximately one-third of infertility cases stem from a female reproductive factor, one-third stem from a male reproductive factor, and one-third stem from a combination of both or unknown causes.

These are some common causes of female infertility.

The majority of female infertility cases are caused by problems with ovulation, the release of a mature egg from the ovaries. There are several causes of ovulation disorders, including the following.

Polycystic ovary syndrome (PCOS), a condition characterized by a hormone imbalance that impacts ovulation. It is the leading cause of female infertility.

Excessive exercise, eating disorders, or stress, each of which can result in hormonal imbalances

Primary ovarian insufficiency, sometimes referred to as premature ovarian failure

Fallopian tube damage or blockage can prevent sperm from reaching an egg, or fertilized eggs from attaching to the uterus. Common causes of fallopian tube damage or blockage include pelvic inflammatory disease — an infection of the uterus and fallopian tubes from chlamydia, gonorrhea, or other sexually transmitted infections — or a prior surgery in the abdomen or pelvis, including surgery for ectopic pregnancy.

Uterine or cervical issues such as the following can disrupt the implantation of an egg into the uterus or increase a woman’s risk for miscarriage.

Benign polyps or fibroids may block fallopian tubes or interfere with the implantation of an embryo. However, many women with these growths are able to conceive.

Structural issues with the uterus that are present at birth

Cervical stenosis, a narrowing of the cervix

Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows elsewhere. The abnormal tissue growth — as well as surgical procedures to remove it — can block the fallopian tubes, preventing the fertilization of an egg. In some cases, endometriosis may interfere with implantation of the fertilized egg, or embryo.

Male infertility is most often an issue of sperm production — including the quantity and quality of sperm produced — or of sperm mobility, which affects the sperm’s ability to find and fertilize an egg. A blockage in the testicle or damage to the reproductive organs can also contribute to male infertility.

Age is a factor in both male and female fertility issues. The quality and quantity of a woman’s eggs begin to decline as she enters her mid-thirties, and age factors into the success rates of in vitro fertilization (IVF).

Many individuals and couples first learn of a fertility issue after trying to conceive without success, and the primary symptom of infertility is the inability to get pregnant. There aren’t always noticeable symptoms, but the following may indicate an underlying fertility problem.

A menstrual cycle that’s irregular, absent, longer than 35 days, or less than 21 days

Unusually light or heavy bleeding during menstrual cycles

Erectile dysfunction or low sex drive in men

The timeline for seeking fertility treatment depends on your age. If you are under the age of 35, most health experts suggest consulting a reproductive specialist after a year of trying to conceive. If you are between 35 and 40, you may want to pursue testing or treatment after six months of trying to become pregnant. And if you are over 40, you may want to pursue testing or treatment before you start trying to conceive.

An evaluation for fertility issues and potential treatment begins with a conversation about your health history. Several tests may be used during the diagnostic process, including the following.

An hysterosalpingogram (HSG), an x-ray taken to examine issues within the uterus and fallopian tubes

Blood tests to measure hormone levels related to fertility and reproduction

Ovarian reserve testing, which evaluates the number of viable eggs in your ovarian reserve. These are typically used for women over 35 or those at risk of a low egg count for other reasons.

A semen test is used to diagnose most cases of male infertility. This identifies how many sperm you produce and whether the sperm are normal in shape and movement — healthy sperm have an oval head and long tail. In some cases, additional blood tests and/or genital ultrasounds may be used to rule out other health conditions.

Fertility problems do not mean that you won’t be able to have children biologically. There are many treatment options that can help increase your chances of conception. The most effective course of treatment depends on the underlying cause of your or your partner’s fertility issues. These are among the most common fertility treatments.

Forms of assisted reproductive technology (ART) including in vitro fertilization (IVF), a process in which eggs and sperm are fertilized in a laboratory and then placed into the uterus with the potential outcome of a pregnancy. In addition to treating female infertility, IVF can also be used when male infertility is a factor.

Intrauterine insemination (IUI), a type of artificial insemination in which sperm that have been washed and concentrated are placed directly into a woman’s uterus during ovulation.

Injectable fertility medications including gonadotropins and oral fertility medications such as Clomid® and Femara® can treat fertility-related hormonal imbalances.

Your doctor may also recommend lifestyle changes or treating a related health condition.

Since 2016, Alto has supported more than 50,000 fertility journeys. We understand that fertility treatment is a significant investment — physically, emotionally, and financially — and we see ourselves as a partner in your health.

We offer free, same-day delivery seven days a week and temperature controlled packaging to ensure that your fertility medications always arrive in the right condition. And our fertility-trained pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to offer any support you need.

Reach out any time via phone at 1-800-874-5881, or in-app messaging.

An HIV diagnosis is the beginning of a lifelong health journey, and it’s understandable to experience many different emotions as you process this information. Remember that HIV is manageable, like many other chronic health conditions, and with treatment, you can live a full and active life. Though it may feel overwhelming to take action right after a diagnosis, getting started on HIV medication as soon as possible is critical to protecting your health and others. Here are the most important steps to take as you move forward.

Next Steps After an HIV Diagnosis

More than half of all individuals living with HIV in the U.S. are not at risk of transmitting the virus to others. This is a testament to the effectiveness of antiretroviral therapy (ART), the frontline treatment for HIV.

ART is a combination of medications that stops the progression of HIV and reduces your viral load — the amount of HIV in your blood — to a very low level. When taken as prescribed every day, these medications can help you maintain an undetectable viral load, which preserves the strength of your immune system and protects the health of your sexual partners. Many people living with HIV are able to achieve an undetectable viral load within six months of starting ART.

Finding a healthcare provider for HIV treatment

There are several ways to find a healthcare provider for HIV treatment. If you already have a primary care provider, they may have the experience and knowledge to treat your HIV. If not, they will likely be able to give you a referral. Similarly, if you were tested for HIV at a clinic, ask if they offer ongoing HIV treatment or can refer you elsewhere. You can also use HIV.gov’s search tool to find HIV treatment services near you.

There’s a lot of information to take in when first starting HIV treatment. Having open conversations with your doctor about your questions and concerns can help you feel empowered about your health. It may help you to prepare a list of questions before your first appointment. Here are some suggestions to use as a starting point.

How will you decide which ART medications are best for me?

How will I know if the medication is working?

What is the frequency of follow-up testing and blood work?

Are there things I cannot do because I am HIV positive?

How does HIV affect my reproductive health? (if relevant)

Learning more about HIV and preventing transmission

Living with HIV often feels more manageable when you’re equipped with facts and confident in your understanding of the condition. In addition to asking questions during doctor’s appointments, explore trusted resources like the CDC's website and HIV.gov to familiarize yourself with the basics of HIV treatment and prevention.

Many individuals are concerned about the risk of potentially transmitting HIV to a partner. There are things you can do to prevent transmission and keep your sexual partners safe. Being consistent with HIV treatment in the long term can virtually eliminate your risk of transmitting HIV to others so long as you maintain an undetectable viral load. This is why one of the most important things you can do, for both your health and others, is to start ART as soon as possible. In addition, your partner or partners may want to speak with their doctors about PrEP, an HIV prevention medication that can lower risk of sexual transmission of HIV by 99% when taken daily. Many individuals who have an HIV-positive partner take PrEP for HIV prevention.

You may be wondering who to tell about your HIV diagnosis. While sharing your HIV status with sexual partners may feel uncomfortable or scary, it will allow them to take steps to protect their health. Some states have laws that require you to share your HIV status with sexual partners. These laws also account for the risk of HIV transmission through intravenous drug use and require you to disclose your HIV status with anyone you share drugs or needles with, if relevant.

Sharing your HIV status with all of your healthcare providers is also important. It will allow them to provide individualized health recommendations, coordinate with the rest of your care team, and take appropriate precautions during blood draws and other procedures.

Many individuals living with HIV find it helpful to share their status with close friends and family as they process their diagnosis. Each person’s experience of HIV is unique, and deciding if and when to tell loved ones about your status is a personal choice. It can be helpful to hear how others decided to share their HIV status. The CDC has a collection of stories about life with HIV, and Positive Spin is another resource highlighting personal experiences of HIV.

The stress of living with any chronic condition can impact your mental and emotional well-being, and those with HIV have a higher chance of developing mental health disorders such as depression.

It’s important to take your mental health as seriously as your physical health and seek any support you need. Use your HIV treatment provider as a resource. They may be able to recommend treatment or prescribe medication, if needed, or refer you to a psychiatrist or psychologist for additional support.

Navigate HIV treatment with Alto by your side

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with antiretroviral therapy. We will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best option for your needs at the best price. To learn more, reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

Since certain types of cancer treatments and procedures can temporarily or permanently impact both male and female fertility, it’s important to have a discussion about fertility with your oncologist as soon as possible. Read on to learn more about fertility preservation options and financial resources for those recently diagnosed with cancer.

Fertility Preservation Options After a Cancer Diagnosis

A cancer diagnosis can bring much uncertainty. If you are considering having children in the future, you may be wondering how your options for cancer treatment will affect your reproductive health. Fertility preservation treatments like egg or sperm freezing can bring peace of mind during this potentially overwhelming time, allowing you to leave open the possibility of starting a family after cancer treatment.

There are several ways that cancer treatments can affect your fertility, including the following:

Surgery to treat cancer of a reproductive organ — such as in the prostate, testes, ovaries, or cervix — may lead to infertility.

Chemotherapy-induced changes in hormone levels can lead to early menopause for women and decrease sperm production in men.

Radiation therapy near the reproductive organs, abdomen, pelvis, or spine may damage eggs or sperm cells depending on the dose and level of radiation.

Hormone therapy used in the treatment of breast cancer and other types of cancer may affect fertility, though these effects are often temporary.

The extent to which these cancer treatments may impact your fertility depends on your personal health history — including your age and baseline fertility — and the duration and dosage of treatment. Your care team can provide a clearer sense of what to expect based on your health and treatment plan.

Many individuals of reproductive age choose to freeze their sperm or eggs for future use before beginning cancer treatment.

Sperm freezing is a fairly simple process in which a person’s sperm is collected, analyzed by a doctor, and, if viable, frozen in vials with cryoprotectant agents and stored for future use.

In the egg freezing process, fertility medications stimulate egg production and maturity. The eggs are retrieved in a minimally invasive procedure and then frozen and stored for future use. There is also the option of freezing embryos, which are eggs that have been fertilized with sperm.

There are several ways that you can use your frozen sperm, eggs, or embryos to have children biologically in the future after cancer treatment. Intrauterine insemination (IUI) is a process that allows you to use your frozen sperm and have it placed into your partner’s or a surrogate’s uterus.

In vitro fertilization (IVF) is a process in which eggs and sperm are fertilized and then placed into the uterus with the potential outcome of a pregnancy. Women who have previously undergone cancer treatment might use this process to have their frozen eggs or embryos implanted into their own uterus. If using eggs rather than embryos, there will be the additional step of fertilizing the eggs with a partner or donor’s sperm. If you had a hysterectomy to remove all or part of your uterus during cancer treatment, you can have your embryos implanted into a gestational carrier’s uterus.

Given the urgency of cancer treatment and the important timing of fertility medications during an egg freezing cycle, you will likely have to make quick decisions about fertility preservation, often within a few days of receiving a diagnosis. Your oncologist may refer you to a fertility specialist called a reproductive endocrinologist who can answer questions about cancer treatment and fertility and help you understand your fertility preservation options. It isn’t uncommon to begin taking fertility medications the same day as your consultation with a reproductive endocrinologist. 

If your oncology team does not know that fertility preservation is a priority for you, do not be afraid to take the initiative in starting the conversation. Be sure to get clarity on how moving forward with the fertility preservation process might impact the timing of your cancer treatment and what your oncologist recommends. Depending on your treatment plan, you may also want to ask about radiation shielding, which can be used during cancer treatment to protect the ovaries or testicles and limit how much radiation they are exposed to.

It’s important to take the financial aspects of fertility preservation treatments into account when planning for the future. While these treatments are significant financial investments, there are resources that can alleviate some of the costs of treatment, including programs designed specifically for those in cancer treatment and survivors.

If Alto is your fertility pharmacy, your fertility medication protocol likely includes medications manufactured by EMD Serono or Ferring Pharmaceuticals. Both companies offer financial assistance for individuals whose fertility has been affected by cancer treatment.

EMD Serono donates fertility medications to eligible cancer survivors diagnosed during their reproductive years through the Livestrong Fertility Discount program. Start the application process on Livestrong’s website to learn if you are eligible.

Ferring Pharmaceuticals provides some fertility medications at no cost for individuals pursuing fertility preservation before cancer treatment. To be eligible, you must be a female U.S. citizen or permanent resident with a cancer diagnosis who has not received chemotherapy within the previous six months. To apply, learn more about Ferring’s Heartbeat program online, or call 1-888-347-3415. (Residents of Arkansas, Massachusetts, or New Jersey can call 1-877-252-0553.)

Read our previous post on financial planning for egg freezing.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881. You can also request a price quote online.

There’s a lot to cover during a consultation, so you may find it helpful to prepare a list of questions in advance. Our fertility pharmacy experts offer some suggestions to get you started below.

Blog

Choosing the Right Birth Control for You

AMH Testing in Fertility Treatment

How Polycystic Ovary Syndrome (PCOS) Affects Fertility

Infertility, Explained

Next Steps After an HIV Diagnosis

Fertility Preservation Options After a Cancer Diagnosis

Top Questions to Ask Your Fertility Clinic

Celebrating National ERG Day at Alto

A Financial Planning Guide for Egg Freezing

Male Infertility: Causes, Symptoms, and Treatment

What to know about RESOLVE: The National Infertility Association

What to Know About Using PEP to Prevent HIV Infection

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