Just because you have had treatment for cancer doesn’t mean you will have problems with fertility – but this is something you need to think about if you are about to start treatment, and may want to have a family in the future.

• On this page you’ll find general information on fertility and how different cancer treatments can impact on your fertility.

• If you are about to start cancer treatment and would like to know more about your fertility options, check out our fact sheet on fertility options before treatment for women.

• If you would like information on fertility options after completing cancer treatment, check out our fact sheet on fertility options after treatment for women.

What does fertility mean?

• Fertility is the ability to have a baby that is biologically yours - meaning that it has your genes or DNA.

• Infertility is the inability to have a baby that is biologically yours and can be the result of either the woman or the man not being able to conceive.

• Not all cancer and treatments affect your fertility. Some - depending on the dose, type, location and the way the body reacts - may have an impact.

• Infertility is something that happens to members of the general population as well, not just to people who have had cancer treatment.

How can having cancer affect my fertility?

Not all cancer and cancer treatments affect your fertility.

But it is really important to chat to your doctor or nurse as soon as possible to find out about the risks and issues before you start your treatment, so you know whether you need to make some decisions about protecting your fertility.

You may not have this option before you started treatment because of your type of cancer.

Cancer treatments and how they can affect fertility

Chemotherapy

Chemotherapy is the most common form of cancer treatment.

Unfortunately, while chemotherapy can stop cancer cells growing and multiplying, it can also affect normal, healthy cells in the process. Reproductive cells fit into this category, so this includes eggs, and the hormone producing cells around the eggs.

The extent of the damage is determined by a number of different factors:

• Drug type

• Dosage

• Combination of medications

• Your age

With all of the things described above it is best to check with your doctor to see what the effect may be.

Chemotherapy can also have some late effects that may complicate any future pregnancy and delivery. You should chat with your oncologist or doctor when you begin to think about starting a family, to ensure that you have taken into account any special considerations.

Radiotherapy

• Radiotherapy uses high-energy x-rays, gamma rays or electrons to kill cancer cells in a specific part of the body. It creates shifts in the body’s cells that destroy the cells’ ability to grow and divide.

• Radiotherapy only affects the cells and tissues within a specific area (unlike chemo, which affects the whole body). Normal, healthy cells are also better able to resist the radiation, which is why your body may recover from the effects of radiotherapy faster.

• Radiation also kills rapidly dividing cells, such as reproductive cells, but is generally limited to those in a contained area. So this is why it can impact your fertility if you are having radio in that area.

The amount of damage that radio can do to your reproductive organs depends on a number of things:

• The dosage

• The number of treatments (called fractions) required

• Your age

• The field of radiation

Hormone treatment

Some cancers (such as breast cancer) use anti-hormone therapy as treatment. Some of the medications used will cause ovarian suppression, but this is usually only temporary and fertility will return once you stop taking the medication.

Bone Marrow Transplant (BMT) and Stem Cell Transplant (SCT)

Having a transplant means that you will be given high-dose chemotherapy and/or total body irradiation (TBI). There is a higher risk of infertility due to the reasons outlined under chemotherapy and radiotherapy (above).

Surgery

Having surgery to the reproductive organs such as the ovaries, uterus, fallopian tubes or cervix may impair your ability to conceive or carry a child. Some of the areas where you might have surgery are:

• The ovaries

• The cervix

• The uterus and other organs

• The vagina or vulva

It is best to chat with your doctor about what the impact of surgery may be on your reproductive organs.

What could happen once I have treatment?

Temporary ovarian failure

Sometimes the ovaries stop functioning temporarily and periods stop, but then things kick start again and the periods start coming again. This happens when the ovaries still have some eggs left but somehow get confused. This is known as temporary time of ovarian failure (or ovarian resistance).

Permanent ovarian failure

It is very common for this to happen while you are undergoing treatment and it may happen for some time after you finish treatment (from months to years). Unfortunately it can also be permanent.

What is premature ovarian failure?

Whilst you may regain ovarian function after your cancer treatment and start having your periods again, you have will have fewer eggs left than you normally would. This puts you at risk of going into premature ovarian failure. Once this occurs you will have much greater difficulty in conceiving a child.

This is NOT the case for everyone who has chemotherapy or radiotherapy. But it may happen for some people.

Resources

To order a free copy of our fertility book, Maybe Later Baby for young people with cancer visit our order resources page.

For more information on fertility clinics and other relevant stuff visit: www.fertilehope.org

For information on places where you can have your fertility tested visit the Sexual Health and Family Planning Website.