How chemotherapy might affect your fertility

Unfortunately, some chemotherapy treatments may cause infertility. Infertility is the inability to become pregnant or to father a child. This may be temporary or permanent, depending on the drugs that you have. It is strongly advised that you discuss the risk of infertility fully with your doctor before you start treatment. If you have a partner, they will probably wish to join you at this discussion. Then you can both be aware of all the facts and have a chance to talk over your feelings and options for the future.

Although chemotherapy can reduce fertility, it is quite possible for a woman having chemotherapy to become pregnant during the treatment. Female partners of a man having chemotherapy may also become pregnant. Pregnancy should be avoided during chemotherapy in case the drugs harm the baby.

 

Female fertility Back to top

Some drugs will have no effect on your fertility, but others may temporarily or permanently stop your ovaries producing eggs. If this happens, it means that you can no longer become pregnant and it will also bring on the symptoms of the menopause|. During chemotherapy your periods may become irregular or stop. You may also have hot flushes, dry skin and vaginal dryness.

In about a third of women, once the treatment ends, the ovaries start producing eggs again and their periods return to normal. It may be a few months before this happens. In this case, the infertility will have been short-term.

Usually, the younger you are, the more likely you are to have normal periods again and still be able to have children once the chemotherapy has ended.

Depending on the type of cancer you have, your doctor may be able to prescribe hormone replacement therapy (HRT) to help relieve the menopausal symptoms. However, HRT cannot prevent infertility.

Male fertility Back to top

Some chemotherapy drugs will have no effect at all on fertility, but others may reduce the number of sperm produced or affect their ability to reach and fertilise a woman's egg during sex. Unfortunately, this means you may no longer be able to father children. However, you will still be able to get an erection and have an orgasm.

You should use a reliable barrier method of contraception throughout your treatment

If you want to have children after your treatment you may be able to ‘bank’ some of your sperm for later use, before you need to start chemotherapy. If this is possible in your case, you will be asked to produce several sperm samples over one or two weeks. These will then be frozen and stored so that they can be used later to try to fertilise an egg and make your partner pregnant. You may be charged a fee for sperm storage. You should be entitled to one course of infertility treatment on the NHS.

Some men will remain permanently infertile after their treatment has stopped, while others will find their sperm count returns to normal levels and their fertility comes back. Sometimes it may take a few years for fertility to return. Your doctor will be able to do a sperm count to check your fertility when your treatment is over.

Teenage boys should also be aware of the infertility risk so that, if possible, their sperm can be stored for later years.

Feelings about infertility Back to top

It can be devastating to learn that the treatment you need for your cancer may also mean you can no longer have any children. If you had been planning to have children in the future or to have more children to add to your family, infertility may be very hard to come to terms with. The sense of loss can be very painful and distressing for people of all ages. Sometimes it can feel as though you have actually lost a part of yourself. You may feel less masculine or less feminine because you can't have children. Women may be especially distressed that the drugs may bring on the menopause, which can further undermine their self-confidence.

People vary in their reactions to the risk of infertility. Some people may shrug it off and feel that dealing with the cancer is more important. Others seem to accept the news calmly when they start treatment, and find that the impact doesn't hit them until the treatment is over and they are sorting out their lives again.

There is no right or wrong way to react. You may want to discuss the risks and all your options with your doctor before you start treatment. You may also find it helpful to talk to a trained counsellor about any strong emotions which threaten to become too much for you.

Your partner will also need consideration in any discussions about fertility and future plans. You may both need to speak to a professional counsellor or therapist specialising in fertility problems. They can help you to come to terms with your situation.

Your doctor may be able to refer you to a specialist. Our nurses| can discuss any problems you may have and help you to find a counsellor who can offer you help and advice.

Pregnancy and cancer Back to top

If you are pregnant before your cancer is diagnosed and your chemotherapy starts, it is important to discuss with your doctor the pros and cons of continuing with your pregnancy. It is sometimes possible to delay starting chemotherapy until after the baby is born, or, sometimes, chemotherapy can be given in the later stages of pregnancy. It will all depend on the type of cancer you have, the extent of the disease, how advanced the pregnancy is and the particular chemotherapy you will be having.

You will need to talk to your doctor about your pregnancy and be sure you are fully aware of all the risks and alternatives before making any decisions. You can also talk to the our nurses|.