“It’s important to think about the optimal timeline for family planning,” says Rozenblit. Even if you’re not thinking about having kids soon, you may want to consider procedures like egg harvesting to protect your ability to grow your future family.
Young people with BRCA variants often feel pressure to have kids earlier than they’d like to so they can have their ovaries removed preventively, says Raimonda Goldman, DO, the chief of medical oncology at Holy Name health system in New Jersey. Luckily, alternatives exist thanks to fertility preservation (more on this below).
For those with a cancer diagnosis, Goldman refers all her young patients to a fertility specialist before they start chemotherapy so they can also discuss fertility preservation strategies.
Consider Preventive Surgery and Fertility Preservation
Some women with BRCA mutations choose to have preventive surgery to lower their risk of cancer. Two common surgeries include:
- Salpingo-oophorectomy: Removal of the ovaries and fallopian tubes reduces the risk of ovarian cancer by 80 to 90 percent.
- Bilateral mastectomy: Removal of both breasts reduces the risk of breast cancer by about 90 percent.
Experts recommend ovary removal between ages 35 and 40 for BRCA1 carriers, says Rozenblit, and between 40 and 45 in BRCA2 carriers. If you’re considering an oophorectomy, Rozenblit recommends fertility preservation, which involves stimulating the ovaries and removing eggs.
These eggs are then cryogenically frozen and saved until you need them. What’s more, when a provider chooses eggs to implant in the future, they can test for the BRCA mutations and choose eggs with no variants, so you won’t pass on your BRCA gene variants to your kids, says Rosenblit.