If you are thinking about getting pregnant after cancer treatment, it is a good idea to talk to your cancer doctor first. You may have worries and questions about fertility that did not seem important before cancer treatment.
The decision to try for a baby is a big one for anyone to make. If you have had cancer, this can bring extra challenges. Some people choose not to have children after cancer treatment.
Depending on your age and the type of cancer and treatment you had, they your doctor may suggest trying sooner or waiting a bit longer. They will also give you advice about any health checks you need before trying to get pregnant.
There is no evidence that cancer treatments harm children conceived after treatment. But doctors usually advise you to use contraception for a while after treatment to allow your body to recover.
If you are taking hormonal therapies for breast cancer, it may be possible to stop treatment temporarily so you can have a baby. Your cancer doctor can give you information about the risks and benefits of doing this.
If you get pregnant but the cancer treatment has increased the risk of miscarriage or premature birth, you will be looked after by a team of specialists during the pregnancy.
If you have been trying to get pregnant for six months or there is a risk that your fertility will not recover, you can have tests to check your fertility.
Cancer and family history
Some people worry about passing cancer or cancer genes onto their children. Cancer cannot be passed from a parent to child.
A small number of people have an inherited cancer gene that makes their risk of getting cancer higher. But this is rare and most cancers are not caused by inherited cancer genes. Talk to your doctor if you are worried about the risk of cancer running in your family.
- What type of contraception should I use and for how long after cancer treatment?
- When should I have tests to check my fertility?
- My partner and I want to try to get pregnant naturally. When can we start trying?
- What are my options for having children?
The number of eggs in your ovaries is called your ovarian reserve. Cancer treatment can reduce your ovarian reserve so that you get to the menopause at an earlier age than you would have.
Usually a woman is referred to a fertility clinic after 1 to 2 years of trying to get pregnant. But women who have had cancer treatment can be referred for fertility testing sooner. This is because of the increased risk of early menopause after cancer treatment.
Fertility tests can help to measure your ovarian reserve or how close you are to the menopause. They do not always show whether or not you can have children. They may help you decide what to do next and whether you want to have fertility treatments.
Your doctor will ask you about your periods and take blood tests. You may also have an ultrasound scan of your ovaries to look at the follicles which contain the eggs. Taking the contraceptive pill or hormone replacement therapy (HRT) can affect the results of some of these tests. Tell your doctor if you are taking either of these.
Some women’s periods come back months or years after cancer treatment. If your periods change, you can have these tests repeated. Your doctor will talk to you about the options available to you.
If cancer treatment has damaged your fertility or made it difficult to have sex, you and your partner may decide to have fertility treatment.
Fertility treatment does not always result in a pregnancy. Your fertility expert will discuss this with you.
The NHS will usually pay for several fertility treatments, depending on your situation. There are rules about fertility treatment in the NHS. If you decide to have fertility treatment, it is important to remember that these rules will apply to your partner as well as to you. Fertility treatment rules and funding vary across the UK. Your local fertility doctor will be able to give you information about this.
Many children have been born using fertility treatments. There do not appear to be any long-term health risks to the child. There is also no evidence that fertility treatments increase the risk of your cancer coming back. Your fertility doctor can give you more information about any possible risks with these treatments.
- Intra-uterine insemination (IUI)
After cancer treatment some women find having sex difficult. If your fertility has come back, you may choose to have sperm put into your womb at the time when your ovaries are most likely to release an egg. This procedure only takes a few minutes and feels similar to having a smear test.
- In vitro fertilisation (IVF)
Eggs are mixed with the sperm in a laboratory to see if an egg fertilises and becomes an embryo. The embryo is then transferred into the womb.
- Intra-cytoplasmic sperm injection (ICSI)
A fine needle is used to inject a single sperm directly into an egg. This is done in the laboratory. If an egg is successfully fertilised, the embryo can be placed in your womb to see if a pregnancy develops.
Using your frozen embryos
When you are ready to try to get pregnant after treatment, the embryos are thawed. A doctor will place them in your womb to see if they implant. Usually, no more than one or two embryos are placed in at a time. You and your partner who provided the sperm for the embryos both have to give permission for this.
If you did not have eggs collected before cancer treatment, you could use donated eggs or embryos. This may be suitable if cancer treatment damaged the ovaries but you are still able to carry a pregnancy.
Embryos are sometimes donated by other couples who have had fertility treatment previously. They may have several embryos stored and have to decide what to do with them when their family is complete.
Occasionally women choose to have their own eggs fertilised with a donor’s sperm.
Choosing to use donated eggs, sperm or embryos can be a difficult decision. It is not funded by the NHS in all areas. There is also a shortage of donors, so it may not be an easy option. The fertility doctor will offer you and your partner counselling about this.
Everyone who donates eggs, sperm or embryos is carefully selected:
- Usually a donor is matched as closely as possible for eye and hair colour, physical build and ethnic origin.
- The donor has to be fit and healthy with no medical problems.
- The donor is tested for infectious diseases such as HIV, hepatitis B and C and some genetic conditions.
Adoption and fostering
If medical treatment does not feel like the right way for you to become a parent, you could consider adoption or fostering.
Adoption means becoming the legal parent of a child. Fostering means looking after a child who can’t stay with their own family – this might be short-term or long-term.
People from all backgrounds can apply to become a parent in these ways. Sexuality, gender and disability are not barriers. And you don’t have to be in a relationship or married.
Adoption and fostering can be rewarding ways to start a family. They are arranged through an organisation or local authority. If you want to find out more, ask:
Surrogacy is where a woman, called the surrogate (or host), becomes pregnant and gives birth to a baby for you. The pregnancy may be started using IUI (intrauterine insemination) or IVF (in vitro fertilisation). You may decide to use:
- your own eggs or embryos
- donated eggs from the surrogate or another donor.
Some women who cannot carry a baby themselves choose surrogacy. It is not very common in the UK and there are laws that can make it a complicated process. Some organisations, such as Childlessness Overcome Through Surrogacy (COTS) and Surrogacy UK, offer detailed information about this.
Talking to other people can be helpful while you are thinking about your options. Macmillan’s Online Community is a good place to start. You can also talk things over with our cancer support specialists free on 0808 808 00 00.
If you prefer to talk to a counsellor, your GP or cancer doctor can help to arrange this. Many hospitals also have specialist nurses who can offer support, and fertility clinics will have a counsellor you can talk to.