Talking about your fertility before cancer treatment starts

Some cancer treatments can affect your fertility (your ability to have children). For some women the possibility of losing their fertility can be very difficult to accept. Fertility in women depends on having:

  • a supply of eggs from the ovaries
  • suitable hormone levels
  • a healthy womb (uterus).

Before your treatment starts, talk to your doctor or nurse about how your fertility may be affected. It’s not always possible for doctors to predict what will happen. Your age and planned treatment can help give an idea of your individual risk. Try to think about the questions you want to ask your doctor or nurse so you can get all the information you need. If you have a partner, it’s usually a good idea to include them too.

You may be able to visit a fertility expert before you start treatment to look at ways to increase your chances of having a baby later on. This depends on when your treatment has to start.

Fertility in women

This section is for women who want information about the effects of cancer treatment on their fertility (the ability to have children). It explains the possible effects of treatments and ways of preserving or protecting your fertility.

Being told you have cancer and that the treatment may make you infertile can be very difficult. For some women the possibility of losing their fertility can be as difficult to accept as the cancer diagnosis itself. You may have planned to have children in the future or may not have thought much about it before now. You may find it helpful to talk to someone about how you feel. We have more information about this and the support that’s available.

Female reproductive system

Fertility in women depends on having:

  • a supply of eggs from the ovaries
  • suitable hormone levels
  • a healthy womb (uterus).

You’re born with a large number of eggs and as you get older, the number and quality of your eggs decreases. When there are very few left, you go through the menopause.

To have a child, one of your eggs needs to be fertilised by a sperm. Once a month, from puberty to menopause, one of the ovaries releases an egg.

This process is controlled by hormones (the body’s chemical messengers) which are produced by the pituitary gland (in the brain) and the ovaries. The ovaries make the main female hormones – oestrogen and progesterone.

The egg moves along the fallopian tube where it can be fertilised by a sperm. Then it continues to the womb (uterus), where it can bury itself into the womb lining and grow into a baby. Hormones prepare the lining of the womb for the fertilised egg. If the egg isn’t fertilised, you have a period.

Female bladder ovaries labelled
Female bladder ovaries labelled

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The menopause

The menopause is when a woman has a change in her hormone levels, stops releasing eggs and stops having periods. This happens naturally between her mid-40s and mid-50s and means an end to fertility.

As well as periods stopping, other symptoms can be:

  • hot flushes and sweats
  • vaginal dryness
  • mood changes
  • altered concentration
  • a low sex drive.

Some cancer treatments can affect the ovaries and bring on an early menopause. Others can cause a temporary menopause or menopausal symptoms.


Talking to your medical team about infertility

It’s important to talk to your cancer doctor or specialist nurse about your risk of infertility before treatment starts. Try to think about the questions you want to ask so you can get all the information you need. If you have a partner, it’s usually a good idea to include them too.

Doctors may not be able to predict exactly how your fertility will be affected. But your age and your planned treatment can help give an idea of your individual risk. In some situations, it may be possible to reduce the effects of treatment on your fertility.

Some women are referred to a fertility expert before starting cancer treatment to discuss ways of increasing their chances of getting pregnant in the future (fertility preservation). But this isn’t always possible for various reasons – for example, there may not be enough time if cancer treatment has to start immediately.

If you’ve already had cancer treatment and are having difficulty getting pregnant, your doctor can refer you to a fertility clinic. The fertility specialist will tell you about the options available to you.

Back to Fertility in women

Getting support

Many women find it helpful to talk to family, friends, counsellors or other women in similar situations when coping with infertility.