How cancer treatment can affect fertility

When you’re young and diagnosed with cancer, you need to think about loads of things you probably haven’t thought about before – and that might include whether you want to have kids.

Fertility means the ability to have children and some cancer treatments can affect your fertility. If doctors recommend one of these to you, it’s worth thinking hard about your options.

Even if kids are the last thing on your mind right now, in a few years’ time you might feel differently. And there are things you can do now to increase your chances of having a family in the future.

Chemotherapy and radiotherapy can affect your fertility, and so can surgery on parts of the body involved in reproduction – like ovaries and testicles.

This won’t be the case for everyone – plenty of people have these treatments and go on to have kids – but it’s important to talk to your doctor about the likely effects of your treatment.

Cancer treatments can sometimes affect your fertility by: 

• Messing up your sperm production
• Messing up the production of hormones involved in reproduction
• Damaging nerves and blood vessels in your groin, making it difficult to get an erection or come.

If this could happen to you, it might be possible for you to freeze your sperm now in a sperm bank – making it more likely that you could still have a family in the future. Your doctor will be happy to let you know more about this.

If you’ve started having your periods, cancer treatment can sometimes affect your fertility by: 

• Messing up the production of hormones involved in reproduction
• Affecting your ovaries
• Damaging the lining of your womb, or requiring your womb to be removed if you have certain types of cancer.

It’s also possible for chemotherapy to make you have an early menopause. That’s the name given to the time when women stop producing eggs. In the UK, the average age for a woman to reach the menopause is 51, but it’s possible for it to happen during or soon after cancer treatment.

If any of these things could happen to you, it might be possible for embryos (eggs that have been fertilised), eggs or tissue from your ovaries to be frozen and used in the future. Your doctor will be happy to let you know more about this. 

Your periods might stop or become irregular during your treatment, but this doesn’t mean there’s no chance of you having children. Periods often come back after treatment is over. Chat to your doctor or clinical nurse specialist about this if you’re worried.

It’s not a good idea to try to have a baby during cancer treatment, as the treatment could harm your baby. It can happen, though, so if you do have sex during treatment, make sure you play it safe. You can chat to your doctor about the best type of contraception for you (and doctors talk about things like that every day, so there’s no need to be embarrassed). 

It’s usually best to wait a while before trying for a baby after treatment, so check with your doctor or clinical nurse specialist if you’re thinking about starting a family.

After having cancer treatment, you can be tested to check your fertility levels. It’s worth thinking carefully about this and maybe chatting to someone close to you about how you would deal with bad news.

It might be that you would prefer not to be tested, or to wait. And remember that infertility caused by treatment can be temporary – so your first test result isn’t necessarily a final result.

Never be afraid to ask questions about your cancer. Ask, ask and ask again. And if you don’t understand the answers you get, keep asking until you do. 

When you talk to your doctor about fertility, you might like to ask: 

• Whether treatment will affect your fertility
• Whether it will affect you permanently or temporarily 
• Whether it’s possible for you to store eggs or sperm
• Whether the treatment could affect your periods
• What contraception will be best for you during treatment
• What fertility treatments might be possible after treatment
• How long after treatment you should wait before trying to get pregnant
• Whether any other treatments might work.