Can Fertility Be Affected by Cancer and Treatments?

How are Cancer Treatments and Fertility Linked?  

There are many common conditions that can impact a person's ability to plan for reproduction and the growth of their family. Cancer and its treatments can have an impact on fertility at many points of the experience, including before, during, or after treatment.

Even if you are not sure if you want to have children in the future, it is recommended that you explore the potential impact of your treatment on fertility, as well as your options, with a reproductive specialist.  

 What Do Fertility and Infertility Mean? 

  • Fertility is the ability to conceive a biological child.   

  • Infertility is the inability to conceive a biological child.  

  • Biological means that you are genetically related.   

 What Treatments or Factors Can Cause Infertility?  

  • There are many contributing factors to infertility and cancer. Some cancer treatments may affect fertility due to effects on hormones, organs, or glands that regulate hormones, like the hypothalamus, ovaries, testes, or uterus.   

  • The type of treatment, comorbidities, and age at the time of cancer diagnosis can impact fertility.  

  • Cancer treatments may damage or destroy the cells essential for reproduction or damage the reproductive organs themselves.  

  • Specific types of chemotherapy are known to affect fertility. One class of medications with an elevated risk of damage to reproductive cells are alkylating agents.    

  • Radiation therapy to specific parts of the body, including abdomen, pelvis, lower spine, testicles, prostate, or to the pituitary gland in the brain may cause problems with fertility. 

  • Surgical removal of certain glands or organs may affect fertility including, but not limited to, removal of the prostate, one or both testicles, ovaries, uterus, or hypothalamus.  

  • Hormone therapies used to treat certain cancers, including breast cancer in women, may affect fertility. Depending on the patient, treatment, and other factors, infertility associated with treatment may be either temporary or permanent. 

What is Fertility Preservation?  

Fertility preservation refers to procedures or interventions used to protect your ability to conceive a child after treatment. To make an informed decision about your future, it is important for you to fully understand the impact your cancer treatment could have on future fertility.  

Discussions about fertility can be complex and multifaceted. Given the effects that many cancer treatments may have on reproductive function, you should discuss your risks of infertility, and any risks associated with future goals of conception as soon as possible, ideally before you initiate treatment. In some cases, it is safe to undergo fertility preservation before treatment. In other cases, starting treatment may be urgent, not allowing time for fertility preservation.  

Questions to Consider When Making the Fertility Choice That is Best for You

  • How important is it for you to have a biological child?  

  • How comfortable are you using assisted reproductive technology?  

  • What concerns do you have about the safety or risks of any reproductive technology or fertility treatments?  

  • Are there religious, cultural, or ethical factors that impact your decision?  

  • What are the perspectives of any spouses or partners?  

  • Are there financial considerations to utilizing reproductive technologies?  

  • Does your state provide mandated coverage for fertility treatments related to cancer treatment?

Prevention and Treatment of Infertility  

Fertility preservation options are best pursued before the start of treatment, if your doctor deems it safe.

Some options you may consider include:  

  • Sperm banking   

  • Egg freezing  

  • Embryo cryopreservation  

  • Ovarian suppression  

  • Ovarian tissue freezing   

  • Radiation shielding   

It is important to remember that even if it is not possible for you to have biological children (or children that share your DNA), it may still be possible for you to be a parent.

Here are some alternatives: 

  • Donor sperm or eggs  

  • Donor embryo 

  • Adoption 

Preventing Pregnancy During Treatment  

Certain treatments can damage your reproductive cells, but not render you infertile. It is important to use contraception while undergoing treatment. Discuss with your oncologist which methods of contraception are suitable for you and your partner. In certain cases, like with some breast cancers, there are types of birth control that may not be recommended.   

Tips from the Iris Team 

  • Schedule time to speak with a fertility counselor. Concerns and emotions regarding fertility can be very complex, both physically and financially. A fertility counselor can best provide you with options and next steps.   

  • Consider scheduling time with one of our Iris Mental health therapists. Decisions about your fertility can be hard to navigate from an emotional standpoint. A mental health therapist, social worker, or spiritual advisor can help you address your concerns and/or fears, and counsel you on ways to communicate these feelings to your loved one.  

  • Be honest and open with your oncologist. Finding time to discuss fertility concerns with your oncologist can be difficult. Appointments are often short, and much information may be discussed that can distract you from discussing all your concerns. Writing down the specific topics you would like to discuss prior to your appointment can help keep you on track.  

  • Make time for ongoing discussions with your loved ones. As situations and feelings come up, discussing these changes with your loved one, as well as with a mental health therapist, can be beneficial.