How does cancer treatment affect fertility?

Undergoing cancer treatment can significantly impact your body, affecting healthy tissues, organs, and even fertility. We understand how disheartening this can be, especially if you have always hoped to have a baby. However, it may still possible to conceive if you preserve your fertility before treatment.

Cancer treatments and their affect on fertility

Different cancer treatments can affect fertility in various ways. This will depend on your circumstances and the type of treatment.

Chemotherapy

Chemotherapy is used to treat different types of cancer and can be administered through the vein or via tablets.

Certain chemotherapy medications can impact female infertility by reducing the number of eggs stored in the ovaries. This can lead to early menopause, which is when the menstrual cycle becomes irregular and eventually stops, resulting in infertility. Symptoms of early menopause can include hot flushes, dry skin, and mood swings. It's important to know that age also plays a risk factor for women. So, the younger the patient, the less likely they are to experience early menopause.

Chemotherapy can also impact male fertility, by reducing and in some cases stopping sperm production.

Higher doses of chemotherapy are more likely to impact the ovaries or sperm production, especially if it is given before a stem cell transplant. Moreover, having a combination of different drugs can have an increased impact on ovaries and sperm production compared to having a single drug.

Radiation therapy

Radiation therapy also known as radiotherapy, uses high radiation rays to destroy cancer cells. It can affect your fertility if part of the reproductive system or pituitary gland is being treated.

For women, radiation therapy can impact egg production and reduce both the quantity and quality of eggs produced. During treatment, it can affect the function of the ovaries and womb. Fortunately, many patients experience improvements after treatment and may still be able to conceive. However, this is not guaranteed for everyone.  

If radiation therapy is given directly to the womb and ovaries, it can trigger early menopause. While it is possible to become pregnant after radiotherapy, there is a significantly increased risk of miscarriage or premature birth.

For male patients, radiation can reduce the amount and quality of sperm produced and can also impact the semen. If an individual finds that no fluid or only a small amount of fluid is released during ejaculation, this indicates that they have stopped producing semen.   

Surgery

A common treatment for cancer is surgery which can impact fertility if it involves the reproductive system.

For female patients, some cancers may require the removal of the womb (hysterectomy), ovaries, or both. If the ovaries are removed, conception will no longer be possible. However, if the ovaries remain, you may still have the option to have a child through surrogacy using your own eggs or donor eggs.

Small cancers can sometimes be removed from the cervix through procedures such as cone biopsy or trachelectomy. Depending on the type of surgery you undergo, it's important to discuss with your doctor how it may affect your fertility and the options available to you.

For male patients, testicular cancer is typically treated with surgery. It is uncommon for both testicles to be removed; if one is removed and the other is healthy, fertility should remain unaffected.

Furthermore, prostate cancer may also be treated with surgery, but removal of the prostate gland can impact erections and sperm production. If you have any concerns, you can speak to your doctor for further advice and guidance.

Hormone therapy

With certain types of cancers, hormonal therapy helps to block or reduce the number of hormones in your body, which can potentially slow down or stop cancer growth.

This type of therapy is used to help manage and treat prostate and breast cancer. In the case of prostate cancer, hormonal therapy can lower testosterone levels, which can impact sperm production. For breast cancer, hormone therapy helps reduce oestrogen levels, which can also affect fertility. Medications that are used include tamoxifen, aromatase inhibitors and fulvestrant.

When hormonal therapy is complete, your fertility may improve and you can undergo fertility tests to check if the cancer has affected your chances of

Reviewed by Justin Chu, Medical Director at TFP Oxford Fertility.