Cancer – and some cancer treatments – can directly impact your reproductive health.

There are ways that you can preserve your fertility before you begin cancer treatment though – and it's definitely worth considering, even if you haven't thought about having children yet.

Cancer treatments that can affect your fertility include chemotherapy, radiotherapy and surgery on your reproductive organs, including the ovaries and testicles.

Hormone therapies and other treatments may also have an impact on fertility, but less is known about the effects of these treatments. 

How cancer treatments can affect fertility in women

Chemotherapy, bone marrow transplant, radiotherapy, surgery and targeted and biologic therapies all affect fertility in women.

Chemotherapy

Chemotherapy drugs can damage a woman's eggs. But the exact effect will depend on the woman's age, the type of treatment she gets and what the drug doses are. If you're wondering which chemo drugs are most likely to affect your fertility, your doctor will be able to talk you through them and the associated risks. 

Bone marrow or stem cell transplant

A bone marrow or stem cell transplant usually involves high doses of chemo and sometimes radiation to the whole body. In most cases this permanently stops a woman’s ovaries from releasing eggs.

Radiation therapy

Radiation can also damage a woman's ovaries. High doses can destroy some or all of the eggs in the ovaries and might cause infertility or early menopause. Even if radiation is not aimed at the ovaries, the rays can bounce around inside the body and might still damage the ovaries. To find out more about how radiation can affect fertility talk to your doctor. 

How cancer treatments can affect fertility in men

Chemotherapy

Chemo works by killing cells in the body that divide quickly. Since sperm cells fall into that category, they are easily damaged by chemo. The risk of chemo causing infertility varies depending on the patient's age, the type of drug used and the doses of drug given. After chemo treatment, sperm production may slow down or stop altogether. Some sperm production usually returns in one to four years, but it can take up to 10 years. 

Hormone therapies

Some hormone therapies used to treat prostate or other cancers can affect sperm production. Talk to your doctor about whether it’s safe to start a family while taking these drugs.

Bone marrow or stem cell transplant

High doses of chemo in a bone marrow or stem cell transplant can cause lifelong infertility – permanently preventing a man from making sperm.

Radiation therapy

Radiation at high doses can kill the stem cells that produce sperm. Even when a man gets radiation to treat a tumour in his abdomen, his testicles may still end up getting enough radiation to harm sperm production.

You shouldn’t start a pregnancy until radiation treatment in completed. Speak to your doctor about how long exactly you need to wait.

Surgery

In some cases, men might need their prostate or testicles removed. As long as a man has one healthy testicle, he can continue to make sperm after surgery. But if a man needs both testicles removed, then he wouldn't be able to father children unless he banked sperm before surgery. 

After your cancer treatment

Some men and women decide to have a fertility test to find out whether or not they are fertile following cancer treatment. Others prefer to wait or not take the test at all.

There are always ways you can start a family following cancer treatment. Fertility treatment is available for couples who have been affected by cancer or a cancer treatment. 

If you are considering fertility treatment, or you'd like to still try for a baby naturally, speak to your GP, who will be able to advise you about the best possible course of action. 

What are the signs and symptoms of infertility? Read our eBook Common Signs of Infertility to find out more.

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Andrew Drakeley

Mr Andrew Drakeley is the Clinical Director at the Hewitt Fertility Centre, working principally at the Liverpool Women’s site but with managerial responsibility for Knutsford.

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