Cancer treatments and fertility
Before you start cancer treatment, your cancer doctor or nurse will talk to you about your treatment options and the possible side effects.
When you are diagnosed with cancer, it can feel like everything happens very quickly. You may need some time to adjust to what is happening. It can help to talk to family and friends or someone else you trust.
The main treatments for cancer are:
- chemotherapy
- hormonal therapy
- targeted therapy
- immunotherapy
- radiotherapy
- surgery
- stem cell transplants.
Cancer treatments can affect your fertility in different ways. It is always best to ask your healthcare team for more information. We have more information about different cancer treatments.
You may feel less interested in sex during cancer treatment. Some treatments can cause side effects that make having sex difficult. This can also affect your chances of getting pregnant or making someone pregnant.
You can find out more about coping with sexual problems in our section on cancer, sex and relationships.
How treatment can affect fertility in men
Cancer treatments may:
- stop or reduce sperm production
- cause problems with erections or ejaculating
- affect testosterone production.
Sperm
Some cancer treatments damage the cells that make sperm. This means you may make less sperm, or sperm that is not very healthy. Your body may still make semen, so you will still ejaculate (come). But there may be less sperm, or no sperm, in the semen. This means there is less chance of fertilising an egg.
After some types of treatment, the cells that make sperm may recover. But it is hard to know exactly when this will happen. Having your semen tested is the only way to know if you are
producing healthy sperm again. Your doctor will arrange these tests for you after your treatment has finished.
Remember, having cancer treatment does not mean your sperm will definitely be affected. If you are having sex and do not want to have a baby, it is important to use contraception.).
Erections and ejaculating
Your pelvic area is the area between your hips and your belly button. Sometimes cancer, or cancer treatment to the pelvic area, can damage the nerves and blood supply to the penis and testicles.
Damage to this area can cause problems with getting an erection or how you ejaculate.
This does not happen often. But if it does, the damage can be permanent. You may still be able to have fertility treatment and use your own sperm to have a baby.
Testosterone
Some cancer treatments reduce your levels of the hormone testosterone. This can cause:
- difficulty getting an erection
- less interest in sex
- thinning of the bones (osteoporosis)
- tiredness
- low mood.
If your testosterone levels do not recover, you can take testosterone replacement therapy (TRT). You usually have TRT as:
- injections
- a gel
- patch on your skin.
TRT can help with sex drive and erections. But your body may not be able to make sperm when you are taking it. This means you may not be able to make someone pregnant while taking it.
But you should still use contraception if you do not want to start a pregnancy.
You can take TRT for the rest of your life. If you want to have children, it may be possible to stop TRT for a while.
How treatment can affect fertility in women
Cancer treatments can cause changes to:
- the ovaries and eggs
- other parts of your body that can affect a pregnancy.
Changes to the ovaries
Some cancer treatments can stop your ovaries releasing eggs. If this happens, you cannot get pregnant. Your periods may stop and you might have some menopausal symptoms. These include:
- hot flushes and sweats
- vaginal dryness
- mood changes
- poor concentration
- less interest in sex.
If your ovaries start working again after cancer treatment, these symptoms will get better. Sometimes your periods may start again, but you may have fewer or less healthy eggs than before. If this happens, you may be less likely to get pregnant naturally.
Early menopause
If you have fewer eggs, you may have less time to get pregnant. This is because you might have an early menopause.
Some people have an early menopause because cancer treatment permanently stops the ovaries working. This means your periods will not come back after treatment and you will not be able to get pregnant naturally. An early menopause is also called premature ovarian insufficiency (POI).
It can be hard coping with early menopause when you are already coping with cancer. If you find any of the symptoms hard or upsetting, talk to your healthcare team for advice about treatments that can help. They can arrange for you to talk to a specialist and get extra support.
Pregnancy and giving birth
Some cancer treatments can make it harder for your womb to carry a pregnancy for 9 months. This may mean there is more risk of losing a baby (miscarriage) or of giving birth early. If you have a higher risk of these problems, you will have extra check‑ups and specialist care during your pregnancy.
Being pregnant and giving birth is hard work for your body. This might be a problem if cancer treatment has affected how well your heart or kidneys work.
If you are thinking about having a baby after cancer treatment, ask your doctor for advice. They may arrange for you to see a specialist. You may also have extra tests to check your heart and kidneys.
Some cancer treatments make it impossible for your body to carry a pregnancy or give birth. There may be other ways to start a family, such as surrogacy or adoption.
