Doha: While breast cancer is widely recognised for its physical and emotional toll, a less discussed but deeply personal impact lies in its effect on women’s fertility. According to Professor of Obstetrics and Gynecology and Chair of Women’s Services at Sidra Medicine, Dr. Johnny Awwad, fertility loss remains one of the most distressing consequences for young breast cancer patients, which can often be prevented through early medical intervention.
“Breast cancer is the most common cause of cancer in young women,” said Dr. Awwad. “Chemotherapy protocols can damage the ovaries and deplete egg reserves, sometimes leading to temporary or permanent infertility. For women in their reproductive years, this can be devastating, especially as diagnosis often coincides with the time they are planning to start families,” he told The Peninsula.
Dr. Awwad explained that among various breast cancer treatments, chemotherapy poses the greatest risk to fertility, as the drugs are toxic to the rapidly dividing cells in the ovaries. Radiation therapy can also harm the ovaries if the pelvis is targeted, while hormonal therapies such as tamoxifen and aromatase inhibitors mainly delay, rather than destroy, ovarian function.
However, the professor emphasised that fertility preservation options today are far more advanced and accessible than in the past. “The most established methods are egg and embryo freezing, ideally performed before treatment begins,” he said. “When time is short, ovarian tissue freezing offers an alternative. We also use medications to temporarily ‘switch off’ the ovaries during chemotherapy, offering partial protection from damage.”
At Sidra Medicine, women diagnosed with cancer receive rapid, coordinated care that balances urgency with long-term reproductive planning. “We provide appointments within 24 hours to ensure fertility discussions don’t delay cancer therapy,” Dr. Awwad said.
“Our multidisciplinary team includes oncologists, fertility specialists, and mental health counsellors who work together to help patients make informed choices that align with their values.”
Beyond the medical challenges, Dr. Awwad underscored the emotional weight of confronting both cancer and the threat of infertility. “It’s an overwhelming experience. Many women grieve the possible loss of motherhood even as they fight for survival,” he said. “This is compounded by cultural and social expectations, particularly in the Gulf region, where childbearing holds profound social importance.”
In Qatar, where strong family networks and faith play key roles in personal decisions, fertility discussions must be handled sensitively. “Cultural and religious beliefs influence how women approach fertility preservation; for example, choosing between egg or embryo freezing,” Dr. Awwad said. “At Sidra, we ensure care is culturally attuned and respectful, providing a safe environment for women to explore their options.”
Encouragingly, fertility preservation success rates continue to improve. “Embryo freezing has the highest success rates, but both eggs and embryos can offer real hope for future motherhood,” Dr. Awwad said. “The key factor remains age; the younger the patient, the better the outcomes.”
Emerging research in the field of oncofertility is expanding these options further. “We now use ‘random-start’ and ‘dual-stimulation’ protocols to collect eggs faster, without delaying treatment,” he said. “Ovarian-tissue transplantation is also helping young girls regain ovarian function after cancer therapy. These advances make fertility care more precise and promising than ever.”
Dr. Awwad’s message to women newly diagnosed with breast cancer is one of hope and empowerment: “A breast cancer diagnosis does not mean the end of your dream to become a mother. With survival rates exceeding 95% and fertility-preservation methods more successful than ever, you can protect your future family while focusing on healing today. The most important step is to ask for a referral to a fertility consultant as early as possible.”
He also called for stronger collaboration between oncologists and fertility specialists. “Fertility counselling should be a standard part of every cancer diagnosis. When oncology and reproductive medicine teams work together, we ensure no woman begins treatment without knowing her options.”
As awareness grows, Dr. Awwad hopes more women will see fertility preservation not as an afterthought, but as a vital part of cancer care, one that allows them to look beyond survival and toward a future filled with new beginnings.
