Fertility After Cancer: Your Questions Answered

August 29, 2017 | by City of Hope

As cancer treatment has improved in the last few decades, so has the number of young survivors. Today, many men and women who experienced cancer in adolescence or young adulthood go on to live full lives.

For some of them, having a family is an important phase of life after cancer. But cancer can affect the odds of conceiving a baby, for both men and women. Here’s what you need to know about planning for and addressing cancer-related infertility.

Is it safe to get pregnant after cancer?

Pregnancy after cancer treatment appears to be safe for both mother and child. There’s no evidence that being pregnant increases the risk of the cancer recurring. Research suggests that’s true even for breast cancer, even though pregnancy can increase hormones associated with breast cancer development.

Chemotherapy and radiation don’t seem to increase the risk of birth defects in the children of mothers who have been treated for cancer, as long as they wait as least six months to get pregnant. But the right length of time to wait depends on many factors, so it’s best to talk to your doctor about the safest time to pursue pregnancy.

How does cancer treatment affect fertility?

Cancer treatment can affect fertility in several ways.

  • In men, surgery, radiation and some chemotherapy drugs can affect the production of sperm. In some cases, sperm production returns to normal months or years after cancer treatment. But sometimes the problems are permanent.
  • In women, surgery to the reproductive organs (such as the removal of the ovaries or uterus) can permanently affect the ability to conceive and carry a child. Radiation and some chemotherapy drugs can impair egg development. And some types of chemotherapy can affect the body’s hormones, leading to premature menopause.

 

What can I do to preserve fertility before cancer treatment?

For men, sperm can be frozen before treatment and used to fertilize an egg at a later date.

Women may consider these options for preserving fertility:

  • Women may choose to freeze embryos, which can later be thawed and implanted into the uterus or into the uterus of a surrogate. However, that option requires a male partner or a sperm donor.

  • Women may also choose to freeze their unfertilized eggs or ovarian tissue. These techniques have lower success rates than freezing embryos, but they might be a more realistic option for some women.

  • A 2014 study found that when young women with breast cancer took a drug called goserelin with their chemotherapy regimen, they had a lower risk of early menopause and were more likely to get pregnant and deliver a healthy baby.

 

For both men and women, it’s important to ask your health care team questions about these options before beginning treatment. Some of the options may delay treatment, and may or may not be appropriate for your situation.
 

Do I have any options if I didn’t take those steps before treatment?

Cancer treatment can affect people differently. It’s not a given that you’ll have trouble conceiving a child just because you’ve had chemotherapy or radiation in the past. If you’re ready to start a family, talk to your medical team and consider seeing a reproductive oncologist, who can help assess your chances of getting pregnant and discuss your best options.
 

What else should I know?

Infertility alone is linked to depression. The double whammy of infertility and cancer can cause even more psychological distress. If you’re struggling with sadness, stress, anger and/or relationship problems, ask for help. A counselor or therapist can help you work through feelings of loss and grief.

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