For Any Cancer Diagnosis
Q. How do I deal with the possibility of infertility due to my cancer treatments?
Facing the possibility of not having your own children can be upsetting and affect your relationships and how you feel about yourself. If at all possible, before you make a decision about your treatment, take time to explore all the options available to you. Here are some other things you can do:
- Speak to your doctor before treatment about how the effects of surgery, chemotherapy drugs, or radiation might affect your ability to conceive and have children. Ask about options to preserve your fertility or alternative ways to treat your cancer.
- Ask your doctor to make a referral to a reproductive specialist. Sperm and embryo cryopreservation are considered standard practice and widely available; other fertility preservation methods (such as ovarian tissue freezing, ovarian suppression or ovarian transposition) should be considered investigational and be performed in centers with the necessary expertise.
- If you are uncertain about your fertility after cancer treatment, you can test your blood levels of FSH (follicle stimulating hormone) to determine your ovarian health.
- You can consider adoption and surrogacy.
The possibility that one cannot have a child, or an additional child, is a loss and, as with other losses, you need time and space to grieve. You may want to speak with a social worker or join a support group to connect with other women who are experiencing similar feelings.
Other helpful organizations include:
Q. I finished treatment and would like information on fertility issues and cancer survivors. Can you help me?
Unfortunately, one potential effect of cancer and cancer treatment is the loss of fertility in both men and women. Depending on cancer type and treatment methods, your age, and other factors, your fertility may be compromised on a temporary or permanent basis. To determine this likelihood and possible solutions, it is important that you talk to your oncologist and a fertility specialist. The American Cancer Society has a comprehensive document on the main causes and options for cancer-related infertility. For women, causes include:
- damage to your eggs caused by certain kinds of chemotherapy
- damage to your ovaries caused by radiation
- removal of the uterus (hysterectomy) or ovaries (oophorectomy)
- hormonal treatments
If you still have a uterus and ovaries, you may still be able to get pregnant. Some medical professionals recommend waiting 6 months before trying, to avoid fertilization of damaged eggs. A doctor specializing in high-risk obstetrics can check that your ovaries are still functioning and that your heart and lungs are strong enough to withstand pregnancy. If you were not able to freeze embryos (cryopreservation) before beginning cancer treatment but you still have your uterus, you may consider:
- getting implanted with donor eggs through IVF (in-vitro fertilization)
- getting implanted with a donor embryo through IVF
For men, infertility may be caused by:
- damage to your sperm cells caused by chemotherapy
- damage to sperm cells caused by radiation
- surgery to remove your testicles or prostate
- hormonal therapies
Some men recover their ability to produce sperm after cancer treatment (maybe a year or later). If you did not freeze your sperm before treatment but you can still produce sperm, you may consider:
- getting your semen analyzed to determine the level of DNA damage to your sperm
LIVESTRONG has a program called Fertile Hope, which provides information on fertility options at all stages of cancer treatment to help you make an informed decision based on your individual needs. Fertile Hope can also provide financial assistance to help you preserve your fertility before cancer treatment begins. You can also search a comprehensive guide of agencies that deal with the financial, practical, legal, and emotional aspects of infertility.
My Oncofertility has a helpful chart that details options for fertility both before and after cancer treatment, as well as comparisons of cost, time, and success rates of the different procedures.
Because of the practical, financial, and emotional toll of fertitlity issues, please consider joining a support community or seeking counseling. CancerCare has face-to-face, telephone, and online support to help you cope with this stress and other survivorship-related concerns.