Fertility and cancer

Does cancer affect my fertility?

Cancer can affect your fertility in 2 ways:

• if you have cancer in a reproductive organ (for example, the uterus or testes)
• from the side effects of cancer treatment — even if your cancer is not in a body organ that involves reproduction (for example, skin or bowel)

Your doctor will recommend using effective contraception. This is so you don't get pregnant during treatment, which can be dangerous for you and for your pregnancy.

Sometimes fertility problems are temporary after treatment, but in some situations, they can be permanent.

Which types of cancer treatment can affect my fertility?

Surgery

Many types of cancer need surgery to remove a tumour. Surgery to your pelvic organs may affect your fertility. If you have surgery to remove all or part of your reproductive organs, it can also affect your ability to conceive or carry a baby to term.

Chemotherapy

Chemotherapy involves the use of strong medicines that target fast-growing cancer cells. For example, cells like eggs and sperm are fast-growing. Chemotherapy can affect your fertility by affecting the quantity or quality of your eggs, or your sperm, or your menstrual period cycle. Your age, medicine type and dose, and how long you use them, can all influence how chemotherapy affects your fertility.

Radiotherapy

Radiotherapy uses radiation to kill cancer cells, but can also damage nearby healthy cells. Sometimes, this can affect egg or sperm cells. Radiotherapy to the brain can affect how the pituitary gland produces reproductive hormones. This can cause fertility issues if it affects your menstrual cycle or can cause low sperm production.

Hormone therapies

Some cancers grow quickly in the presence of certain hormones. In these cases, your doctor may prescribe medicines that lower the amount of these hormones in your body. Your hormones are important in sperm and egg production and taking hormone therapy for cancer can affect your fertility.

Which cancers of the reproductive organs affect my fertility?

Female fertility and cancer

Cervical cancer affects the cervix, which is at the entrance to the uterus. Surgical treatment may involve removing the whole uterus, and/or all or part of the cervix. Radiotherapy for cervical cancer can also affect the ovaries and lining of the uterus. These are important for maintaining pregnancy. If you still have your cervix, you are likely to be able to conceive, but are at risk of having a miscarriage, going into labour early or having your baby before the due date.

Ovarian cancer usually involves surgery to remove one or both ovaries, fallopian tubes and often the uterus. Removing both ovaries brings on early menopause. Your fertility options will depend on the type of cancer treatment you have.

Cancer of the uterus is often treated with surgery to remove the uterus (hysterectomy). In this case, you won't be able to carry a pregnancy. IVF with a surrogate could be an option.

Male fertility and cancer

Treatment for testicular cancer often involves surgery to remove the affected testicle. Most males with one testicle can fertilise an egg naturally. If you've had chemotherapy or radiation therapy, it may take longer to produce enough healthy sperm for conception to occur.

Can I have more children if I have cancer?

If your cancer treatment is likely to affect your fertility, your health team can discuss your options with you. They may refer you to a fertility specialist before you start your treatment.

The type of cancer you have and how it's treated are important in deciding what fertility preservation techniques will work best for you. Sometimes, you can delay cancer treatment for a few weeks to give you time to consider, or have treatments, to preserve your fertility.

Fertility preservation for females may include egg or embryo freezing and ovarian tissue harvesting. Fertility preservation for males might include sperm banking or testicular sperm extraction. You can usually try to get pregnant between 6 months and 2 years after finishing cancer treatment.

There are other options such as donor conception, surrogacy and adoption if you are unable to conceive naturally.

Will I pass my cancer on to my children?

Most cancers are not passed on from parent to child. Usually, the risk of your children having cancer if you or your partner have it, is the same as anyone else.

Some cancers are related to faulty genes and can be passed on in biological families. You can choose to have genetic testing before trying to get pregnant, to see if you carry any of these genes. You can also use counselling services, specialising in genetics, to learn what the screening results mean for your family.

What happens if I carry a gene that can cause cancer?

If you carry a gene, it does not mean that all your children will have it. Even if they do, they will not necessarily develop cancer. Preimplantation genetic testing is a process that screens your embryos before they are implanted during the IVF process. This will let your doctors check for your cancer-causing gene, so only healthy embryos (without the gene) are used.

Resources and support

Receiving a cancer diagnosis can be overwhelming. Focusing on your treatment and emotions may make it difficult to consider other issues, such as fertility. Speak to your doctor about how cancer and/or cancer treatment may impact your fertility and about your fertility options.

For more information on what options are available, and for advice, guidance or support contact one of these agencies:

• The Royal Women's Hospital, Victoria has produced a video on treatment options for fertility preservation during cancer treatment.
• The Cancer Council has a helpful detailed information booklet for you and your loved ones. They also offer free confidential telephone support on 13 11 20.