Cancer and Fertility: Your Questions Answered
If you, or someone you know, have been diagnosed with cancer, you may have many questions and worries. You may wonder whether you will be able to become a parent once cancer treatment ends.
Here are the answers to 10 common questions about cancer and infertility.
1. Does cancer treatment cause infertility?
Following a cancer diagnosis, it is important to be proactive about your fertility concerns. Some cancer treatments cause infertility, while others do not. Whether cancer treatment affects your fertility depends on:
- The type of cancer you have
- The type and dose of cancer treatment you receive
- Whether you are pre-pubescent or of reproductive age
If you are post-pubertal, your age influences your risk of infertility after cancer treatment. If you do have problems with infertility after cancer treatment, they may not last forever. Some cancer survivors regain their fertility within several years after cancer treatment ends. A fertility specialist can run some tests to help determine your likelihood of conceiving.
2. How will my cancer treatment affect my fertility?
Ask your doctor for details about how your cancer treatment might affect your fertility. For instance, if you take certain chemotherapy drugs in specific dosages, you may experience infertility. If you receive radiation treatment, your fertility may be affected. It all depends on the amount of radiation you receive, and the body parts treated.
3. What should I ask my doctor about cancer and fertility?
Here are some questions you may want to ask your doctor before cancer treatment begins:
- Am I at risk for temporary or permanent infertility following this treatment? If so, is it safe to adjust my treatment to protect my fertility?
- Before I begin treatment, can I pursue fertility preservation options, such as embryo or egg banking?
- When can I consider conception in the future? Should I start taking birth control, or delay conception for a certain period of time?
If your doctor thinks that your cancer treatment could affect your fertility, ask your doctor about birth control and fertility preservation options. Let your doctor know that you feel strongly about protecting your fertility during cancer treatment.
4. Will my doctor help me with my fertility concerns?
The American Society for Reproductive Medicine recommends that cancer doctors (called oncologists) educate their patients on how cancer treatment might affect their fertility. Dr. Jennifer Mersereau, Medical Director at the University of North Carolina Division of Reproductive Endocrinology and Infertility, shares her thoughts on this issue: "Some studies show that many oncologists do not routinely discuss fertility concerns with their reproductive-aged patients. Fertility treatment referrals are less likely to occur if your cancer prognosis is worse, and if you have little time between your diagnosis and start of treatment." If your oncologist does not discuss how cancer might affect your fertility, consider getting a second opinion.
5. What is fertility preservation?
Fertility preservation is a way to protect your eggs (or your partner's sperm) during cancer treatment. Current fertility preservation options for women include:
- Embryo, egg, and ovarian tissue freezing
- Shielding of ovaries during pelvic radiation treatment
- Surgical repositioning of ovaries during radiation treatment
Of these, embryo freezing is the most common and successful procedure. However, in order to freeze an embryo, a woman must have a partner, or use an anonymous sperm donor, to provide sperm to fertilize her egg.
6. What if I cannot freeze an embryo?
For many females, embryo freezing is not an option, for example if a girl is pre-pubertal, does not have a partner, or does not want to create embryos for ethical reasons. So what are these girls or women supposed to do? Egg freezing and ovarian tissue freezing are possible alternatives, but they are still experimental. Only a few thousand babies have been born using frozen eggs, and only a handful with frozen ovarian tissue. If you are stuck, a fertility specialist can help you understand your choices.
7. Can fertility medications help me during cancer treatment?
Some researchers are investigating whether birth control pills and other medications can help protect female fertility during cancer treatment. A GnRH-agonist, such as leuprolide acetate or triptorelin, may induce a temporary, reversible shutdown of the ovaries during cancer treatment. Ask your doctor for more information about these options.
8. What is male fertility preservation?
Fertility preservation for men usually consists of the simple process of freezing a sperm sample at a sperm bank. Once you are ready to have a baby, the following procedures may help you achieve a pregnancy with frozen sperm:
- Intrauterine insemination (IUI) (also known as artificial insemination)
- In vitro fertilization (IVF)
- Intracytoplasmic sperm injection (ICSI)
Other fertility preservation methods are available for men, including testicular biopsy. If none of these treatments are appealing or possible, you may want to consider using donor sperm or looking into adoption.
9. What if I cannot afford fertility preservation?
You may be eligible for financial assistance for fertility preservation. Check out Fertile Hope and Fertile Action for more information.
10. When can I get pregnant after cancer treatment?
Ask your doctor if it is safe for you to have children following cancer treatment. Your doctor may recommend that you wait several years before trying to have a baby. During this time period, your body may be able to heal and resume the production of healthy eggs and sperm.
Medically reviewed September 2011 by Dr. Jennifer Mersereau, Medical Director at the University of North Carolina (UNC) Division of Reproductive Endocrinology and Infertility.