Ask About Fertility Before You Start Chemo

Chemotherapy and some cancer treatments can affect fertility, while several years of hormone therapy may also delay pregnancy until fertility has naturally declined with age. If this matters to you, raise it with your oncologist as early as possible, ideally before treatment begins. Fertility-preservation services, including egg, embryo, and in some centres ovarian-tissue freezing, are available in Singapore, Malaysia, and the Philippines. Rules on who can later use frozen eggs or embryos for IVF vary by country and are noted below.

Embryo Freezing

Established Option

Eggs are fertilised with sperm and frozen as embryos. This requires sperm from a partner or, where permitted locally, a donor. Rules on donor sperm vary by country.

Timing: Before chemotherapy starts

Egg Freezing

No Partner Needed

Eggs are retrieved and frozen without fertilisation. Singapore permits elective egg freezing for eligible women aged 21–37 regardless of marital status; medical egg freezing is also available. Using frozen eggs for IVF is restricted to legally married couples in Singapore. In the Philippines, egg freezing, including emergency freezing for newly diagnosed cancer patients, is offered by centres affiliated with the Philippine Society for Fertility Preservation. In Malaysia, Malaysian Medical Council guidelines generally restrict medically assisted reproduction to married couples, while specifically recognising that unmarried individuals may require fertility-preservation treatment. Confirm details directly with a fertility specialist.

Timing: Before chemotherapy starts

Ovarian Tissue Freezing

Specialist Option / Limited Availability

Ovarian tissue is removed and frozen before treatment. The 2025 ASCO fertility-preservation guideline classifies this as an established method, though availability remains much more limited than egg or embryo freezing. Ask your care team whether this is offered locally.

Timing: Before chemotherapy or other fertility-damaging treatment, whenever possible. Because it does not require ovarian stimulation, it may be an option when treatment needs to start quickly.

A Note on Hormone-Sensitive Cancers

If you have hormone-sensitive breast cancer, special stimulation protocols using aromatase inhibitors are well established and can help minimise estrogen exposure during egg or embryo freezing. Current evidence does not show this increases the risk of cancer recurrence. This is something to discuss directly with a fertility specialist working alongside your oncologist.

A Note on Ovarian Suppression During Chemotherapy

For young women with breast cancer, a GnRH agonist may be offered during chemotherapy to reduce the risk of chemotherapy-related ovarian insufficiency. This is a supplement to, not a replacement for, established fertility-preservation methods like egg, embryo, or ovarian tissue freezing.

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Important: Time Is Limited

Egg or embryo freezing often takes around two weeks, although timing varies and modern stimulation protocols can often begin without waiting for the next menstrual cycle. Ask your oncologist or a fertility specialist as early as possible, even if you're unsure whether you want children. Rules on eligibility and later use of frozen eggs or embryos vary by country (Singapore, Malaysia, and the Philippines), so confirm details with a local fertility clinic.

Content reflects general information as of 2026 and is not a substitute for advice from your own oncology and fertility care team. Laws and availability vary by country and may change.

Sources

Ministry of Health, Singapore — elective egg freezing age limit of 21–37 and requirement that frozen eggs be used for procreation only by legally married couples — moh.gov.sg
Ministry of Health, Singapore — fertility preservation for young cancer patients; MediSave support for medically indicated fertility preservation — moh.gov.sg
Ministry of Health, Singapore — MediShield Life Benefits; coverage of surgical costs for embryo, egg, and ovarian tissue freezing in cases of potential iatrogenic infertility, effective 1 June 2026 — moh.gov.sg
Singapore General Hospital, Fertility Preservation program (Centre for Assisted Reproduction Care) — sgh.com.sg
American Society of Clinical Oncology (ASCO), 2025 fertility preservation guideline — established status of egg, embryo, and ovarian tissue cryopreservation; aromatase-inhibitor stimulation protocols for hormone-sensitive cancers; GnRH agonist use during chemotherapy
Philippine Society for Fertility Preservation, Inc. (PSFP), directory of member centres offering emergency egg freezing for cancer patients and ovarian tissue cryopreservation — psfp.ph
Malaysian Medical Council (MMC), Guideline on Medically Assisted Reproduction (2nd edition, 2025) — restricts medically assisted reproduction to married couples while explicitly recognising unmarried individuals may require fertility-preservation treatment; also prohibits gamete and embryo donation for fertilisation — mmc.gov.my
Bavishi Fertility Institute, patient FAQ on fertility preservation for cancer patients — ivfclinic.com

This version uses first-party MOH sources for all three of Singapore's key claims (age/marriage limits; MediSave support for medically indicated fertility preservation; MediShield Life surgical coverage from 1 June 2026), the ASCO 2025 guideline for clinical claims, Malaysia's 2025 MMC guideline (which distinguishes assisted reproduction for pregnancy from fertility preservation itself), and the Philippines' PSFP as a professional medical society. Content was reviewed and corrected through five rounds of external medical feedback, checked against these primary sources, on 5 September 2026.