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Many people are devastated when they discover that the surgery|, radiotherapy| or chemotherapy| treatment they need for their cancer will mean they can no longer have children.
Infertility is very hard to come to terms with, especially if you were planning to have children in the future, or to have more children to complete your family. The sense of loss can be very painful and distressing. Sometimes it can feel as though you have actually lost a part of yourself. You may feel less feminine or less masculine because you can’t have children. Body changes|, such as the menopause or inability to have an erection, may damage your self-confidence even more.
People’s reactions to the risk of infertility vary. Some people may come to terms with it quickly and feel that dealing with the cancer is more important. Others may 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 nurse or doctor before you start treatment.
You may also need an opportunity to talk to a trained counsellor about any strong emotions that become too much for you. We have a database of helpful organisations|.
If you have a partner, they will also need special 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 hopefully help you come to terms with your situation.
Your doctor or specialist nurse may be able to refer you to a specialist, or you can be put in touch with one directly by contacting the organisations on our database. You can also call our cancer information specialists|. They can discuss with you any problems you may have, and they can also help you find a counsellor who can offer you help and advice. All calls to our support line are made in confidence.
You also might find it helpful to read our section about fertility|.
It can sometimes be difficult to predict whether your fertility will be affected by cancer treatment, or whether it will return to normal when treatment is over. There are a number of things you may be advised to consider that can help you to get pregnant or father a child if cancer or its treatment have affected your ability to do this naturally. These need to be started before your treatment, so it’s important that you discuss the risk of infertility fully with your doctor or specialist nurse before you start. If you have a partner they will probably want to join you for this discussion. Then you can both be aware of all the facts and have a chance to talk over your feelings and the options for the future.
It may be possible to collect and store some of your eggs for later use. Collecting eggs takes about 3-4 weeks and involves stimulating your ovaries with hormones to produce more eggs than normal. The eggs are collected and then fertilised with sperm (from your partner if you have one, or from a donor), to form embryos. The embryos are then frozen. Because this process takes a number of weeks, it may not be suitable if you have to start treatment straight away. Once your cancer treatment is finished and you’re ready to start thinking about having children, one or two embryos can be thawed and placed in your womb.
There’s a risk with some cancers - such as breast|, ovarian| and womb| cancer - that the hormones used to stimulate the ovaries may also stimulate the cancer to grow. Any risks of fertility treatment will be discussed with you.
It’s possible to store unfertilised eggs, however if the eggs are not fertilised before they’re stored, the chance of a successful pregnancy will be low.
Before treatment it may be possible to remove small pieces of ovarian tissue that contain some eggs. These tissue samples are frozen and can be put back into the body at a later date. This way of preserving fertility is still at a very early stage of development and only a few pregnancies have been achieved using this method. Only a few hospitals in the UK are able to store samples. Your doctor or specialist nurse can discuss this with you.
Young women and teenage girls who have started their periods should be aware of any infertility risks of their treatment so that, if possible, they can store embryos, eggs or ovarian tissue.
You may be charged a fee to store your embryos or eggs, and also for any fertility treatment that you decide to have.
If you’ve had your womb removed (hysterectomy|) or had radiotherapy| directly to the womb, you will not be able to get pregnant. Some women may consider adoption or surrogacy, which is when another woman carries a baby for you. Some women choose not to have fertility treatment, adoption or surrogacy and go on to enjoy life without children. Everyone is different.
We have a section about fertility and cancer treatment for women|, which discuss the options for dealing with infertility.
If you haven’t completed your family before you need to start treatment, you may be able to save (bank) some of your sperm for later use. If this is possible, you’ll be asked to produce several sperm samples over a few 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. The pregnancy should then carry on as normal. You may be charged a fee to store your sperm, and also for any fertility treatment.
Young men and boys should also be aware of any infertility risks of their treatment so that, if possible, their sperm can be stored for later years.
If you’re permanently infertile after treatment and don’t have any sperm stored, you and your partner may want to think about using donated sperm. This can be a difficult decision, and you and your partner will be offered counselling and information about the implications.
We have a section about fertility and cancer treatment for men|, which discuss the options for dealing with infertility and has a video of Robert sharing his experience of fertility treatment when he had cancer.
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.