What is fertility?

For women, fertility means the ability to get pregnant. After some types of cancer treatment, women can have trouble getting pregnant. Preserving fertility after cancer treatment involves doing things before or during cancer treatment to raise a woman's chances of getting pregnant later on.

Which cancer treatments can cause fertility problems?

There are three main types of cancer treatments that can cause fertility problems.

  • Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.
  • Radiation therapy – Radiation involves getting high doses of X-rays.
  • Surgery – If a woman's ovaries (female sex organs) are removed, she can't get pregnant. If a woman's uterus is removed, she can't carry a pregnancy.

Chemotherapy and radiation can damage or destroy eggs in the ovaries. As a result, women might stop having periods or have irregular periods. Also, radiation can damage the uterus, which can make it hard to carry a pregnancy.

Not everyone who gets chemotherapy or radiation will have fertility problems. With chemotherapy, it depends on the medicine and dose a person gets. With radiation, it depends on the dose and part of the body treated.

Women

What should I do if I want to have a child someday?

You should let your doctor know before you start your cancer treatment. In some cases, treatment that has a lower chance of affecting future fertility might be available.

Are there other ways to preserve fertility?

Yes. Different things can be done to help women preserve their fertility.

If you are getting chemotherapy, options include:

  • Embryo banking – This involves collecting eggs before you start cancer treatment. A doctor fertilizes the eggs with sperm in a lab to make embryos. An embryo is a group of cells that grow after a woman's egg and a man's sperm join together. The embryos can then be frozen and stored until they are used later on.
  • Freezing and storing eggs (that are not fertilized) or tissue from your ovaries
  • Taking medicines to keep your ovaries from working as well during your cancer treatment

If you are getting radiation, options include:

  • Shielding the ovaries or uterus during radiation treatment – This involves wearing a special shield on the outside of your body during radiation treatment. The shield covers and protects your organs so they aren't damaged by the radiation.
  • Moving your ovaries – If your ovaries are in the path of the radiation, your doctor can perform surgery to move them slightly to keep them from getting damaged.

If you are going through both chemotherapy and radiation, all of the above might be options for you.

How do I decide which option is right for me?

The best way to preserve your fertility depends on your cancer, treatment, age and individual situation. Talk with your doctor about your different choices. To make your decision, you might want to think about:

  • The benefits and downsides of the options
  • How long each option takes—For example, embryo banking takes a few weeks. This could delay the start of your cancer treatment.
  • How well your doctor thinks each option will work
  • How much each option costs—For example, it costs money to collect, freeze and store embryos. Health insurance sometimes pays for these things.

What if I still can't get pregnant?

If you still can't get pregnant after cancer treatment, you have other choices.

  • You and your partner can try to have a baby using a donated egg.
  • You can have another woman (called a "surrogate") carry a pregnancy for you.
  • You might choose to adopt.

Couples can have a tough time making these decisions. You might find it helpful to talk to a counselor or go to a support group for people who are facing the same issues.

Men

What should I do if I want to have a child someday?

You should let your doctor know before you start your cancer treatment. In some cases, treatment that has a lower chance of affecting future fertility might be available.

Are there other ways to preserve fertility?

Yes. There are two main things that can be done to help men preserve their fertility.

  • Sperm banking – This involves collecting and freezing your sperm before you start cancer treatment. To collect your sperm, you will need to ejaculate. If you can't ejaculate, or if there is no sperm in your semen, your doctor can do a procedure to remove sperm from your testicle. After the sperm is collected, it is frozen and stored until needed.
  • Shielding your testicles during radiation treatment – This involves wearing a special shield on the outside of your body during radiation treatment. The shield covers and protects your testicles so they aren't damaged by the radiation.

How do I decide which option is right for me?

The best way to preserve your fertility depends on your cancer, treatment, age and individual situation. Talk with your doctor about your choices. To make your decision, you might want to think about:

  • The benefits and downsides of the options
  • How well your doctor thinks each option will work
  • How much each option costs—For example, it costs money to collect, freeze and store sperm. Health insurance sometimes pays for these things.

What if I still can't father a child?

If you still can't father a child after cancer treatment, you have other options.

  • You and your partner can try to have a baby using another man's sperm from a sperm bank.
  • You might choose to adopt.

Couples can have a tough time making these decisions. You might find it helpful to talk to a counselor or go to a support group for people who are facing the same issues.