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Fertility and cancer

7-minute read

Key facts

  • Cancer can affect your fertility either because it affects an organ involved in reproduction, or because of the side effects of cancer treatment.
  • If you have cancer, you may be able to take steps to preserve your fertility before starting treatment, so you can start or grow your family at a later date.
  • It is important to use contraception during cancer treatment to prevent unplanned pregnancies.
  • Your doctors can refer you to a fertility specialist to discuss your options and treatment.
  • Having cancer and worrying about your fertility can be overwhelming — support is available and it's important to seek help if you need it.

Does cancer affect my fertility?

Cancer can affect your fertility in 2 ways:

  • if you have cancer in a reproductive organ (for example, the uterus or testes)
  • from the side effects of cancer treatment — even if your cancer is not in a body organ that involves reproduction (for example, skin or bowel)

Your doctor will recommend using effective contraception. This is so you don't get pregnant during treatment, which can be dangerous for you and for your pregnancy.

Sometimes fertility problems are temporary after treatment, but in some situations, they can be permanent.

Which types of cancer treatment can affect my fertility?

Surgery

Many types of cancer need surgery to remove a tumour. Surgery to your pelvic organs may affect your fertility. If you have surgery to remove all or part of your reproductive organs, it can also affect your ability to conceive or carry a baby to term.

Chemotherapy

Chemotherapy involves the use of strong medicines that target fast-growing cancer cells. For example, cells like eggs and sperm are fast-growing. Chemotherapy can affect your fertility by affecting the quantity or quality of your eggs, or your sperm, or your menstrual period cycle. Your age, medicine type and dose, and how long you use them, can all influence how chemotherapy affects your fertility.

Radiotherapy

Radiotherapy uses radiation to kill cancer cells, but can also damage nearby healthy cells. Sometimes, this can affect egg or sperm cells. Radiotherapy to the brain can affect how the pituitary gland produces reproductive hormones. This can cause fertility issues if it affects your menstrual cycle or can cause low sperm production.

Hormone therapies

Some cancers grow quickly in the presence of certain hormones. In these cases, your doctor may prescribe medicines that lower the amount of these hormones in your body. Your hormones are important in sperm and egg production and taking hormone therapy for cancer can affect your fertility.

Which cancers of the reproductive organs affect my fertility?

Female fertility and cancer

Cervical cancer affects the cervix, which is at the entrance to the uterus. Surgical treatment may involve removing the whole uterus, and/or all or part of the cervix. Radiotherapy for cervical cancer can also affect the ovaries and lining of the uterus. These are important for maintaining pregnancy. If you still have your cervix, you are likely to be able to conceive, but are at risk of having a miscarriage, going into labour early or having your baby before the due date.

Ovarian cancer usually involves surgery to remove one or both ovaries, fallopian tubes and often the uterus. Removing both ovaries brings on early menopause. Your fertility options will depend on the type of cancer treatment you have.

Cancer of the uterus is often treated with surgery to remove the uterus (hysterectomy). In this case, you won't be able to carry a pregnancy. IVF with a surrogate could be an option.

Male fertility and cancer

Treatment for testicular cancer often involves surgery to remove the affected testicle. Most males with one testicle can fertilise an egg naturally. If you've had chemotherapy or radiation therapy, it may take longer to produce enough healthy sperm for conception to occur.

Can I have more children if I have cancer?

If your cancer treatment is likely to affect your fertility, your health team can discuss your options with you. They may refer you to a fertility specialist before you start your 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. Sometimes, you can delay cancer treatment for a few weeks to give you time to consider, or have treatments, to preserve your fertility.

Fertility preservation for females may include egg or embryo freezing and ovarian tissue harvesting. Fertility preservation for males might include sperm banking or testicular sperm extraction. You can usually try to get pregnant between 6 months and 2 years after finishing cancer treatment.

There are other options such as donor conception, surrogacy and adoption if you are unable to conceive naturally.

Will I pass my cancer on to my children?

Most cancers are not passed on from parent to child. Usually, the risk of your children having cancer if you or your partner have it, is the same as anyone else.

Some cancers are related to faulty genes and can be passed on in biological families. You can choose to have genetic testing before trying to get pregnant, to see if you carry any of these genes. You can also use counselling services, specialising in genetics, to learn what the screening results mean for your family.

What happens if I carry a gene that can cause cancer?

If you carry a gene, it does not mean that all your children will have it. Even if they do, they will not necessarily develop cancer. Preimplantation genetic testing is a process that screens your embryos before they are implanted during the IVF process. This will let your doctors check for your cancer-causing gene, so only healthy embryos (without the gene) are used.

Resources and support

Receiving a cancer diagnosis can be overwhelming. Focusing on your treatment and emotions may make it difficult to consider other issues, such as fertility. Speak to your doctor about how cancer and/or cancer treatment may impact your fertility and about your fertility options.

For more information on what options are available, and for advice, guidance or support contact one of these agencies:

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2023


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What is fertility preservation? Fertility preservation is used to increase the chance of somebody having children in future. It can be used for medical reasons and personal circumstances. It is sometimes used before medical procedures and treatments that may cause infertility, such as cancer treatment and gender transitioning. There are several methods of fertility preservation, including medication to protect a woman’s ovaries (GnRH agonists), and freezing (cryopreservation) of ovarian tissue, eggs or sperm. Freezing eggs, embryos or ovarian tissue Egg freezing Egg freezing is a way of trying to preserve your fertility so you can attempt a pregnancy with IVF in future. Egg freezing offers the potential to preserve fertility but there is no guarantee of a baby, so it is important that you are well-informed about all aspects of egg freezing before you proceed. 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You may consider freezing your eggs because you are: facing medical treatment that may affect your fertility, such as some forms of cancer treatment or gender transitioning not ready to have a child during your most fertile years for personal reasons concerned about your fertility declining as you get older and feel you are not currently in a position to have a child at risk of premature menopause or have endometriosis. What is the process? Your fertility specialist will come up with a plan for your treatment and prescribe medication to stimulate your ovaries. You will then have an egg collection procedure and your eggs will be frozen and stored. Risks A small proportion of women have an excessive response to the fertility drugs that are used to stimulate the ovaries. In rare cases this causes ovarian hyperstimulation syndrome (OHSS), a potentially serious condition. Bleeding and infection are very rare complications of the egg retrieval procedure. 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How many eggs should I store to have a reasonable chance of having a baby? (You might require more than one stimulated cycle to retrieve enough eggs to give you an acceptable chance of success further down the track) What is the approximate total cost, bearing in mind that I may need more than one stimulation and egg retrieval procedure to yield enough eggs? Freezing embryos Freezing embryos can also be used for fertility preservation as part of fertility treatment. Read more about fertility treatment here. Freezing ovarian tissue Freezing ovarian tissue (ovarian tissue cryopreservation) is a relatively new approach used to help women undergoing chemotherapy preserve their fertility. It is a surgical procedure in which a small amount of ovarian tissue is collected, cut into slices, frozen and stored. These tissue slices can be thawed and transplanted back at a later date. The aim is for the woman to start producing hormones and release eggs. Freezing sperm or testicular tissue There are two methods used to preserve fertility in men. Sperm freezing You produce a semen or sperm sample through masturbation in a private room in the fertility clinic. A lubricant is not used as this can damage the sperm. Small amounts of sperm are placed in straws which are carefully labelled. These straws are then frozen and stored in a tank with liquid nitrogen at the clinic. If possible, several samples are stored to make sure there is enough sperm to conceive one or several children. While the freezing process usually affects the quality of the sperm, in most cases plenty of good quality sperm survive. This method is also used for men before they begin cancer treatment or gender transitioning. Once you are ready to try for a baby, you can undergo fertility treatments such as IVF or artificial insemination with thawed sperm. Testicular biopsy Sometimes it is not possible to get a good sample of sperm through masturbation. 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Chemotherapy using alkylating agents such as cyclophosphomide is more likely to affect fertility than treatment with other agents. The dosage. Higher doses of chemotherapy or radiotherapy used for a longer period of time are more likely to affect fertility than lower doses used for a shorter time. In general, the older a woman is at the time of diagnosis, the fewer eggs she will have, the poorer their quality will be, and the more vulnerable her ovaries will be to the effects of chemotherapy. The good news is that there are a number of fertility preservation options for both men and women with cancer to provide you with a good chance of having a baby in the future. Following a diagnosis When you are diagnosed with cancer everything can seem overwhelming. For most, focussing on getting through treatment takes priority. However, it is important that you (and your partner, if any) speak with your doctor (oncologist or haematologist) about how the cancer and treatment can affect your fertility and ability to have a child in the future. Your doctor will be able to take you through the advantages and disadvantages of different treatment options. They can also refer you to a fertility specialist for fertility preservation (both before and after treatment) and the use of contraception to avoid unwanted pregnancy.  What are my options? Advances in technology mean that as time progresses, more fertility preservation options become available, each with advantages and disadvantages. For men, options include sperm freezing or gonadal shielding (for radiation therapy). For women, options include egg freezing, embryo freezing, gonadal shielding or ovarian transposition (for radiation therapy). After treatment you can have a fertility assessment to see if your fertility has been affected. If not, you can try to conceive naturally. If your fertility has been affected, your fertility specialist will discuss the best option to use your stored eggs, sperms or embryos based on your personal circumstances. This may include using IVF, intrauterine insemination, or home insemination. There are also options if you are unable to conceive naturally and did not have the opportunity to preserve your fertility before cancer treatment. These include: donor conception (donated eggs, sperm, or embryos) surrogacy adoption/permanent care Options for transgender & gender diverse people  Fertility preservation is an option for transgender and gender diverse people to have children in the future.  There can be many things to consider when affirming your gender, including whether or not to pursue the option of medical transition. With so much to decide, taking a moment to think about whether you might like to have a family in the future, and understanding what you need to do in order to maximise your fertility options, can sometimes be forgotten in the process. It is important to consult a fertility specialist before medical transition begins to discuss your options for fertility preservation specific to your circumstances. Your fertility specialist will be able to assist you before, during and after medical transition. For trans men (assigned female at birth) Using testosterone will create significant changes to your body, including ceasing your egg production and menstrual cycle. Fertility may be restored if testosterone is ceased, but that cannot be guaranteed. You can take steps to preserve your fertility before beginning hormone treatment. Other reproductive options also exist after transition. Before transition Traditional conception - Choosing to have a child (or children) by having sex or via insemination before undergoing hormone therapy may be an option for some people. Others may not want to proceed in this way for a variety of reasons, including the potential delay to medical transition. Egg freezing - You may preserve your fertility via egg freezing before hormonal therapy begins. This would involve having treatment to develop multiple eggs which would be collected and stored for later use. It is similar to the first part of an IVF cycle in which injections are given and requires internal ultrasounds. Side effects from the medication may be experienced. It is important to keep in mind that egg freezing does not guarantee a successful pregnancy when you are eventually ready to start a family. Fertility treatment - Another option is to create embryos using IVF. Sperm, either from a male partner or a donor will be needed to create an embryo using your eggs. Your embryos will be frozen for later use. If you are partnered with a woman, your partner will be able to carry the pregnancy. Surrogacy is also an option if you are partnered with a man or unable to carry the pregnancy. After transition If you are single or partnered with a man, and have preserved your fertility you could have a child using your stored eggs or embryos with the assistance of a surrogate. You may be able to have a baby if you have not stored eggs or embryos. If you have not had surgery affecting your reproductive organs, it may be possible to cease hormone treatment, begin to produce eggs again, and try to conceive. This approach needs to be carefully managed medically. It may also create additional emotional challenges for you. It is not known whether the health of the child born may be affected by the hormone treatment. Seek additional support and guidance from your treating doctor and counsellor or therapist before and during this process. If you are partnered with a woman you may consider using a sperm donor.  Surrogacy is also an option. For trans women (assigned male at birth) Using oestrogen (and antiandrogen) will, over time, cease the production of sperm and make it difficult (if not impossible) to achieve an erection or ejaculation. It is unlikely that fertility will be restored after a significant period of time on hormones. It is not possible to estimate how long it takes for fertility to be lost. However, reproductive options after transition also exist. Before transition Traditional conception - For those partnered with a woman, conception via intercourse or insemination is the simplest and least expensive method for starting a family although it may be emotionally challenging. Sperm freezing - Sperm can be frozen before beginning hormone therapy. This is usually done via masturbation in a private room at a fertility clinic, although it may be possible to bring the sample from home. 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