Fertility in young women
Cancer, and some cancer treatments, can have an effect on your fertility.
All of a woman’s eggs are stored in her two ovaries. Girls are born with their total number of eggs in their ovaries and no more are made after that.
The doctors talked to me about the possible effects of chemo on fertility, and they also told me to keep an eye on my menstrual cycle because sometimes your periods can become irregular or stop althogether. My periods have been okay though - they stayed regular.
Once a month, from puberty (the age periods start) to menopause (when periods stop), one of the ovaries releases an egg. This process is controlled by hormones produced by the pituitary gland (in the brain) and the ovaries. It’s known as the menstrual cycle.
When an egg is released from the ovary, it moves along the fallopian tube, where it may be fertilised if you’ve had sexual intercourse and there are sperm present. The egg then moves into the womb. If it has been fertilised, you become pregnant - the fertilised egg embeds itself into the wall of the womb to develop into an embryo, then into a foetus and then into a baby.
If the egg is not fertilised, it will be released about 14 days later through the neck of the womb, together with the lining of the womb, as a period.
Eventually, as women get older, the hormone levels in the body change, eggs are no longer released from the ovaries each month and periods stop. This is known as the menopause.
Some cancer treatments can stop the ovaries from producing the hormones that control the menstrual cycle, and so may cause an early menopause. This means that some women won’t be able to have children. This is also known as premature ovarian failure or premature menopause.
Other effects on fertility
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Any problems that stop you having sex may also stop you getting pregnant, even if you’re still making healthy eggs.
Some types of cancer treatment may cause lasting damage to the heart or kidneys, which may make it inadvisable for a woman to become pregnant. If this applies to you, your doctor will give you more information about it.
Cancer treatments and fertility
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The main treatments for cancer are chemotherapy, radiotherapy, surgery, stem cell transplants and hormonal therapy.
For women, cancer treatments such as chemotherapy can affect the way the ovaries work and can result in fewer or no eggs being produced. Some treatments can make periods irregular or stop for a while (known as temporary infertility). Other treatments sometimes cause permanent infertility and bring on an early menopause.
We have more information about how cancer treatments can affect your fertility, which has been written for women of all ages, not specifically for teens and young adults.
During and sometimes after treatment you’ll be advised to use contraception if you’re having sex, even though you and your doctor may not know whether any damage has been done to your fertility. This is so you don’t accidentally become pregnant while you’re still recovering from the effects of the treatment. Barrier methods of contraception (for example condoms) can also reduce the risk of sexually transmitted infections. Your doctor or nurse can discuss this with you.