Facing cancer brings many challenges, and for people who may want children in the future, concerns about fertility can add another layer of complexity. Understanding how cancer and its treatments can affect your ability to conceive or carry a pregnancy is an important step in making informed decisions about your care and future.
Can cancer affect my fertility?
Cancer and cancer treatment may affect fertility. The impact depends on factors such as:
- The type and stage of cancer
- The treatment plan
- Your age and sex
- Whether treatment affects reproductive organs or hormones
Certain cancers may directly interfere with the reproductive system or hormonal balance. For example, cancers that involve reproductive organs can reduce fertility, and some cancers alter hormone levels that control ovulation or sperm production.
For some people, fertility changes may be temporary. For others, they may be permanent.
How cancer treatments can affect fertility
Different cancer treatments can impact fertility in various ways. It's important to understand these risks before treatment begins so you can explore fertility preservation options where possible if you wish to do so.
Chemotherapy drugs target fast-growing cells, including eggs in the ovaries and sperm in the testicles.
- Women: Chemotherapy can reduce or stop ovulation, and periods may become irregular or stop completely. Some women experience premature or early menopause after treatment.
- Men: Chemotherapy can lower sperm counts or affect sperm quality, which can cause temporary or permanent infertility.
Radiation uses targeted doses to destroy cancer cells, but it can also harm nearby healthy tissue.
- Women: Radiation to the pelvis or reproductive organs can damage the ovaries or uterus, sometimes causing early menopause or permanent infertility.
- Men: Radiation to the testes or brain can reduce sperm production or disrupt reproductive hormones.
Surgery may remove or damage parts of the reproductive system.
- Women: Removing one ovary may allow continued fertility, but removal of both ovaries or the uterus results in permanent infertility. In some early-stage cancers, fertility-sparing surgery may be an option.
- Men: Removal of one testicle may still allow natural conception, but removal of both testicles or the prostate results in permanent infertility.
Hormone therapies are used to slow cancers that grow in response to natural hormones.
- Women: Anti-oestrogen drugs used for breast cancer can cause menopause-like symptoms and usually require delaying pregnancy during and after treatment, though they do not damage eggs.
- Men: Therapies for prostate cancer reduce testosterone levels, which can impact sperm production and fertility.
Other treatments
Stem cell transplants, immunotherapy, and targeted therapies may also affect fertility. The risks vary depending on the specific drugs used.
Managing fertility concerns
It is essential to discuss fertility early with your cancer care team. They can provide guidance on preservation options, including egg, sperm, or embryo freezing, and help plan treatments to limit reproductive harm. They can also advise on contraception and hormone management during treatment.
Support from partners, family, or fertility counsellors can help you navigate these decisions.
