Cancer and fertility

It is often not possible to know whether cancer treatment will affect a person’s fertility. Depending on the type of cancer and its treatment, a patient’s fertility may recover, but it could also be temporarily or permanently damaged.

Following a diagnosis

When a person is diagnosed with cancer everything can seem overwhelming, so thinking whether or not they are going to have children in the future may not feel like a priority at the time. For most people, the only thing they want to focus on is getting through the treatment. However, it is important for people with cancer to talk with their doctor about how the disease and its treatment may affect their fertility. It is also a good idea to think about who they might want to include in this conversation.

People with cancer who have not had children, or those who might want to have more children, usually need to take steps to try to preserve their fertility before treatment starts. Their doctor (oncologist/haematologist) can refer them to a fertility specialist for a consultation about fertility preservation – both before and after treatment. It is also essential not to assume that a person’s fertility will be affected by their cancer treatment and to use contraception to prevent an unwanted pregnancy.

The effect of cancer treatment on fertility

Cancer and its treatment can affect a person’s:

  • ovarian function and the production of sperm
  • ability to carry a pregnancy
  • ability to have sexual intercourse
  • feeling about themselves, which may have an impact on relationships.

The factors that may reduce the fertility of a person diagnosed with cancer can include the:

  • type of cancer – e.g. testicular cancer or Hodgkin’s Lymphoma can result in poor sperm count or quality
  • type of treatment – radiation treatment to the pelvis is more likely to lead to infertility than radiation to other parts of the body. Chemotherapy using alkylating agents such as cyclophosphomide is more likely to affect fertility than treatment with other agents.
  • dosage – higher doses of chemotherapy or radiotherapy used for a longer period of time are more likely to affect fertility than lower doses used for a shorter time.
  • person’s age – in general, the older a woman is at the time of diagnosis, the fewer eggs she will have, the poorer their quality will be, and the more vulnerable her ovaries will be to the effects of chemotherapy.

Exploring your options

Advances in technology mean that as time progresses, more fertility preservation options become available to people who face these decisions. Each method has its advantages and success rates. Currently, cancer patients have the following fertility preservation options:

For people with cancer who did not have the opportunity to preserve their fertility before they had cancer treatment and who are unable to conceive, there are options available to help them have children, including:

Additional resources are available for people who would like to learn more on this subject.