Consulting doctor with fertility questions

When someone thinks “cancer,” the first thing that comes to mind may not be starting a family. However, for many younger people who may be thinking about having children, a cancer diagnosis may be prohibitive at first – and certainly worrisome at best.

Beyond the problems of the cancer itself, cancer treatments can have an ill effect on fertility, for both women and men. Standard cancer treatments, including radiation, chemotherapy, and surgery can potentially have long-lasting effects on reproductive health. Moreover, hormone therapies may also affect fertility, but there is not a lot of evidence found about the long-term effects of these types of treatment.

It can be difficult to predict all effects of cancer treatments, but many people who have to undergo treatments for cancer remain fertile and can start their own families in later life. Some patients find that their fertility is not permanently affected. Usually, it depends on individual circumstances, such as gender, treatment paths, where the cancer is located, and age.

Women, Cancer and Fertility

Cancer and its related treatments can affect women of childbearing age through:

  • Damage to the womb (or other organs) by the cancer itself.
  • Preventing ovaries from working, causing early menopause.
  • Stopping the production of hormones necessary for fertility.
  • Surgeries that remove reproductive organs.

However, it’s important to understand that having cancer is not a sentence for having children after the diagnosis. The miracles of modern medicine provide a number of different options for those who may wish to have children after the cancer treatments are done and the disease goes into remission.

Speaking with an oncologist and a fertility specialist about available options before starting prescribed cancer treatments is important. Depending on the diagnosis, prognosis, and other factors, it may be possible to delay treatment long enough to visit a fertility clinic. Clinics can offer information about available alternatives and talk about chances of remaining fertile after cancer treatment.

Some of the fertility options available to women who have been diagnosed with cancer include:

  • Freezing and storing unfertilized eggs.
  • Storing frozen embryos.
  • Freezing ovarian tissue and storing it.

Which options remain available depend largely on the types of cancer, the expected course of treatment, and other factors. Discussing these considerations with the appropriate specialists is an important step to understanding what actions can be taken.

Men, Cancer, and Fertility

Fertility in men is affected by cancer and related treatments through:

  • Stopping the production of hormones like testosterone, which are involved in sexual function.
  • Interfering or stopping the production of sperm.
  • Constricting or damaging of blood vessels and nerves in the pelvic area, which can make it difficult, or even impossible, to ejaculate.
  • Damage or removal of one or both testes.

As for women, men with cancer have some options available when it comes to preserving fertility with a cancer diagnosis. For example, it's possible to store the sperm before starting cancer treatments. In many cases, a man will provide sperm samples over several weeks, before the actual treatment begins. It will be frozen and stored, and then used as a part of your fertility treatment.

However, sometimes cancer treatment cannot be delayed. Every case is individual, so discussing the available options with an oncologist and fertility specialist is the best way to determine what courses of action can be followed in a specific circumstance.

Cancer Treatment and Contraception

It is not recommended for woman to become pregnant during cancer treatments, because some of drugs used to treat cancer can affect the genetic material of reproductive cells (sperm or egg), which could lead to congenital problems with the baby. On the other hand, completely abstaining from sex is may not be desirable for the person undergoing treatment.

It is generally acceptable to use barrier contraception, such as condoms or diaphragms, for those who want to remain sexually active while undergoing cancer treatments. However, many forms of birth control that manipulate hormones, such as estrogen/progestin-based contraceptives, can interfere with chemotherapy or other cancer treatments.

Fertility specialists and oncologists can provide more information about the best contraception solutions for patients who have cancer and are undergoing cancer treatments.

Fertility After Cancer Treatment

Even after finishing cancer treatments, individuals may still have questions about fertility and the possibility of starting a family. Common questions include:

  • How long to wait before trying to have a baby?
  • Can the cancer treatment harm your kids in the future?
  • What might happen if you have a child and the cancer returns?

It's natural to have these and other questions. Most of the time, the answers will depend on the person’s individual situation, diagnosis, and the effects of the treatment on the patient’s body. Only a doctor trained in such issues can provide specific advice and information.