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Women: Protecting Your Fertility Before Cancer Treatment

Learning you have cancer can cause distress, depression, or anxiety. These are normal, common responses. These feelings can be caused by many things. You may have many questions, especially about treatment. You may also have questions about how cancer care may harm your ability to have children (your fertility). If you are thinking about having a child at some point, you can take steps to protect your reproductive health. Talk with your healthcare providers about this and share your fears or concerns. Your cancer care team can talk about available options with you. They can also refer you to appropriate reproductive specialists.

Cancer treatment and your fertility

Not all cancer treatments may affect your ability to have children. It depends on many things, such as:

  • Your age

  • The type of cancer you have

  • The kind of treatment you will have

  • The length and dose of that treatment

Here are a few ways in which some treatments may affect your fertility:

  • Surgery. As part of your care, you may need to have certain organs or parts of them taken out. This may mean reproductive organs, such as both of your ovaries or your uterus. If that is the case, you won't be able to get pregnant after treatment. Some surgeries done in your pelvic area may also harm these organs. That also could lead to fertility problems.

  • Radiation. High doses of radiation can kill cancer cells. This type of treatment may also affect nearby healthy cells. Radiation to your pelvis may cause changes in your uterus or your ovaries. These changes may make it harder for you to get pregnant. Or you may not be able to carry a baby full term. If you have radiation to your brain, it may harm your pituitary gland. This gland may no longer work right. It may not make the hormones needed to start ovulation and your monthly period.

  • Chemotherapy. Some of these medicines can damage your ovaries. These organs may then no longer release eggs. This problem may last for a short time. Or it can be lifelong (permanent), leading to menopause.

  • Other treatments. You may need other treatments that may affect your reproductive system. These include hormone therapy, stem cell transplants, and bone marrow transplants. Your healthcare provider can tell you more about the risks.

Questions to ask about fertility preservation

If you think you may want to have children after your cancer care, talk with your healthcare provider right away. It’s best to talk about your concerns before you start treatment. You may then have more choices for preserving your fertility. Your provider may also have you talk with a reproductive specialist.

These questions can help you start the conversation:

  • What is the chance that my treatment may affect my fertility?

  • What possible side effects could treatment have on my reproductive health?

  • What are my choices for protecting my ability to have children?

  • How long after treatment may I have to wait to try to have a child?

  • How much do fertility preservation methods cost?

Your choices for preserving your fertility

Your healthcare provider can help you choose the best way to protect your fertility. Ask about any risks. One of these methods may work for you:

  • Cryopreservation (egg harvesting). This method removes eggs from your ovaries and then freezes them. You may have the eggs fertilized with sperm before they are frozen. This is called embryo cryopreservation. When you are ready to have a child, an egg or an embryo can then be thawed for use.

  • Ovarian shielding. This option can protect your ovaries while you are having radiation. During treatment, your healthcare provider will place a lead shield on the outside of your body over your ovaries. Or he or she may be able to direct the radiation to a very small area.

  • Ovarian transposition (oophoropexy). This option may be used if you need radiation. A surgeon will move your ovaries and sometimes your fallopian tubes away from the spot that will get radiation. He or she may put them on your stomach wall until you are done with treatment.

Researchers are studying new ways to protect the fertility of people who need cancer treatment. One of these may also be a choice for you through a clinical trial. Talk with your healthcare provider or reproductive specialist to learn more.

Date Last Reviewed: 5/1/2019
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