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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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Unfortunately, some chemotherapy treatments can 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’s important that you discuss the risk of infertility with your doctor before you start treatment. If you have a partner, they’ll probably want 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’s still possible for a woman having chemotherapy and for a female partner of a man having chemotherapy, to become pregnant during the treatment. But, pregnancy should be avoided during chemotherapy as the drugs could harm the baby. Our section on contraception| has more information.
Some chemotherapy drugs don’t affect fertility, but others may temporarily or permanently stop your ovaries producing eggs. If this happens, you will no longer be able to become pregnant and you may develop symptoms of the menopause|.
Your periods may become irregular or stop, and you may have hot flushes, dry skin and vaginal dryness.
In about a third of women, once the treatment ends, their 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. 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 can’t prevent infertility.
Before your treatment starts, it’s important to know if your fertility is likely to be affected. You can then decide whether you want to look at options that may be available to you, such as storing embryos (fertilised eggs) or eggs for future use. If you have a partner, it might be helpful for you both to be present during these discussions. We have a separate section that discusses the options for women dealing with infertility|.
Some chemotherapy drugs will have no effect 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’ll 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. The clinic where you provide your sperm sample will be able to give you more details. You should be entitled to one course of fertility treatment on the NHS.
Some men will remain permanently infertile after their treatment has stopped, while others find their fertility and sperm count returns to normal. 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. We have information for men dealing with infertility|.
It can be devastating to learn that the treatment you need for your cancer may also mean you can no longer have children.
If you had been planning to have children in the future or to have more children, 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 like you have lost a part of yourself. You may feel less masculine or feminine because you can’t have children. Women may be especially distressed if the drugs bring on the menopause, which can further undermine self-confidence.
People vary in their reactions to the risk of infertility. Some may 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’s 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 about your feelings and concerns with a trained counsellor.
Your partner also needs to be involved in discussions about fertility and future plans. You may both need to speak to a professional counsellor or therapist specialised in fertility problems. They can help you come to terms with your situation.
Your doctor may be able to refer you to a specialist. Our cancer support specialists| can discuss any problems you may have and help you to find a counsellor who can offer you help and advice.
If you have already started your chemotherapy when you find out that you are pregnant, it’s important to discuss with your doctor the pros and cons of continuing your pregnancy. It’s also important to discuss your options if you are pregnant and due to start chemotherapy.
It may be 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’ll be having. 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 should not breastfeed during chemotherapy treatment as the drugs could be passed to your baby through the milk. If you want to continue to give your baby breast milk during your treatment you may be able to express extra milk before the chemotherapy starts. The breast milk can be frozen until it’s needed. If you freeze the milk in small quantities of about 20ml, you don’t have to waste any by thawing large amounts at a time.
It may be possible to start breastfeeding again once your chemotherapy is finished, if you’re still able to produce breast milk. You may be able to express milk throughout your chemotherapy so that you’re still producing milk when the treatment finishes. Any breast milk that is expressed during the chemotherapy treatment should be thrown away. Having chemotherapy won’t affect your ability to produce breast milk in the future.
Your doctor or specialist nurse can give you more advice about breastfeeding and chemotherapy.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.