Future Fertility for Cancer Survivors

Before your cancer treatment began, your oncologist may have spoken to you about your future ability to have children if you were of childbearing age. He or she may also have discussed ways to preserve your fertility, such as collecting and storing healthy eggs or semen before beginning cancer treatment for use after treatment ended.

Now that you have completed your cancer treatment, you may be ready to start or grow your family. Here are answers to some of the most common questions cancer survivors have as they consider expanding their families. 

Fertility after Cancer Treatment: Common Survivor Concerns

After cancer treatment, will I be able to have children? 

Your cancer care team is your best resource as there is no one-size-fits-all answer to this question. The most accurate answer for you depends upon the type of cancer you had, the treatments you received, and how your body responded.

Women

• Chemotherapy - Some types of chemotherapy are more likely to cause infertility than others by causing egg damage or by leading to early menopause. View the list on the American Cancer Society website.  
  
  Certain chemotherapy drugs can weaken the heart, which may make pregnancy dangerous.
   
• Radiation therapy - When given internally (brachytherapy) or externally to the abdomen or pelvis, which does include the lower spine, reproductive organs like the uterus, cervix, and ovaries can result in infertility. If radiation includes the brain, the pituitary gland can be affected, which can also result in infertility.
   
• Surgery - Surgical removal of all or part of the uterus, cervix, one or both ovaries, or pelvic lymph nodes can hinder a woman’s ability to become pregnant or carry a pregnancy to term. 

Men

• Radiation therapy and Chemotherapy - With either radiation therapy or chemotherapy, there is a risk of reduced sperm counts which can affect fertility. In some cases, sperm production can normalize, usually over 10-24 months after treatment, but sometimes it is permanent.
   
• Surgery - Surgical removal of the prostate, bladder, one or both testicles, or pelvic lymph nodes may cause infertility in men.

How long should I wait after cancer treatment before trying to conceive a child?

If your doctor advises that you can safely conceive (and carry a child if you’re a woman), there is no concrete rule about how long to wait. Because cancer treatment can damage the DNA of sperm, men are typically encouraged to wait two to five years after treatment ends before trying to conceive a child naturally.

For women, most oncologists recommend waiting at least 6 months from the date of their final chemotherapy to try and get pregnant as eggs damaged during cancer treatment should leave the body within that time frame. In some cases, oncologists may recommend waiting up to five years before trying to conceive as some additional therapies may be recommended after chemotherapy and radiation is complete.

While many survivors worry that cancer treatments increase the risk of conceiving a child with birth defects, studies have found no increase in the rates of birth defects in children conceived by a parent who has undergone cancer treatment. 

Is there a possibility of passing cancer along to a new baby?

There is no evidence that conceiving a child after cancer treatment increases that child’s risk of developing cancer. If you have had one of these cancers, there may be an increased risk that your child will develop that cancer during their lifetime. This does not mean your baby would develop cancer, it just means his or her risk may be higher than that of the general public. 

Cancers that may have a genetic link include breast cancer, colon cancer, ovarian cancer, and prostate cancer. Genetic counseling and possibly genetic testing can help you understand the risks more clearly.

Listen to our podcast episode about fertility after a breast cancer diagnosis. 

On this episode of Cancer Care Connections, Dr. Nina Balanchivadze, oncologist and oncofertility expert at Virginia Oncology Associates, talks about how young women diagnosed with breast cancer can preserve their dreams of motherhood. Learn about the specific challenges young women with breast cancer may face regarding fertility preservation and the importance of preserving ovarian function during cancer treatment.

Regardless of Your Post-Cancer Fertility, You Can Still Become a Parent

Even if your cancer treatment has caused you to become infertile that doesn’t mean you can’t become a parent. Thanks to donor eggs, donor sperm, surrogates who will carry your fertilized embryo to term, adoption, etc., you can still have the family you’ve dreamed of, even if your journey to parenthood is different than you had imagined.