Certain types of cancer, and many types of cancer treatment, can have a lasting impact on fertility. Because of this, many people with cancer choose to have treatment to preserve their fertility before starting cancer treatment.

Does cancer affect my fertility?

In most cases, it is cancer treatment rather than cancer itself that affects fertility. Because of this, your doctor might advise you to use effective contraception so you do not get pregnant during cancer treatment since this can be dangerous for you and for your pregnancy.

Which types of cancer treatment can affect my fertility?

Surgery

Many types of cancer require surgery to remove a cancerous tumour. Surgery to your pelvic organs may affect your fertility. For example, scarring can make it more difficult for you to conceive. Surgeries to partly or completely remove your reproductive organs can also affect your ability to conceive or carry a pregnancy to term.

Chemotherapy

Chemotherapy involves the use of strong medicines that target fast-growing cells, including cancer cells. As reproductive cells like eggs and sperm are also fast-growing, chemotherapy can affect your fertility temporarily or permanently by affecting the quantity or quality of your eggs or your partner’s sperm, or your menstrual cycle. Your age, your medicine type and dose, and how long you use them can all influence how much chemotherapy affects your fertility.

Radiotherapy

Radiotherapy uses x-rays to kill cancer cells but can also damage nearby healthy cells. Sometimes, this means egg or sperm cells are affected. Radiotherapy close to the pituitary gland in the brain can also affect its production of reproductive hormones. This can cause fertility issues if it affects your periods, or causes low sperm production in your partner.

Hormone therapies

Some cancers grow more quickly in the presence of certain hormones. In these cases, your doctor may prescribe medicines that reduce the amount of these hormones circulating in your body. If this happens, your periods may become irregular or stop altogether, affecting your ability to conceive. This type of therapy can also cause a reduction in sperm production.

Which cancers of the reproductive organs affect fertility?

Cervical cancer affects the cervix, located at the entrance to the uterus. Surgical treatment for cervical cancer may involve partial or complete removal of the cervix. Although this surgery alone is not likely to affect your ability to conceive, it can increase the chance of you going into labour too early.

Ovarian cancer often involves surgery to remove one or both ovaries. Removal of both ovaries brings on early menopause, and you would need to undergo in-vitro fertilisation (IVF) to conceive.

Cancer of the uterus is often treated with surgery to remove the uterus (hysterectomy). In this case, you won’t be able to become pregnant.

Treatment for testicular cancer often involves surgery to remove the affected testicle. Most men with one testicle can go on to fertilise an egg naturally. Sometimes, other treatments used for testicular cancer, such as radiotherapy, can affect sperm production in the remaining testicle, leading to lower sperm quality and/or quantity.

I have cancer but want to have more children. What are my options?

If your cancer treatment is likely to affect your fertility, your health team will discuss your options with you before you start cancer treatment. The type of cancer you have and how it’s treated are important in deciding what fertility preservation techniques will work best for you. Often, cancer treatment can be delayed for a few weeks so you have time to consider or undergo treatments to preserve your fertility.

Fertility preservation techniques for women may include egg or embryo freezing and ovarian tissue harvesting. Fertility preservation for men might include sperm banking or testicular sperm extraction.

Will I pass my cancer on to my children?

Most cancers are not passed on from parent to child. A small number of cancers can be passed on through the parent’s genetic material — their eggs or sperm. You can choose to have genetic testing before trying to conceive to see whether you carry any of these genes. Genetic counselling services can advise you further about what your genetic screening results mean for your family.

What happens if I am found to be carrying a gene that can cause cancer?

Some treatment options allow your medical team to screen your embryos before they are implanted during an IVF process. This will let them check for the presence of cancer-causing genes so that only healthy embryos that do not carry the gene will be implanted.

Who can I talk to for information and support?

Receiving a cancer diagnosis can feel overwhelming. Your emotions will understandably make it difficult for you to consider other issues — including fertility. Speak to your doctor about how cancer and/or cancer treatment may impact fertility in your specific circumstances, and about your choices for preserving fertility.

For more information and support call Pregnancy, Birth and Baby on 1800 882 436 to speak to a maternal child health nurse.

The Cancer Council also provides free confidential telephone support on 13 11 20.