Cancer and fertility

Some cancers can affect your reproductive system and fertility. Reproduction is the way we produce babies; when a persons’ eggs and sperm work together to create a baby.

Some types of cancer and treatments can cause changes to our bodies that impact the reproduction processes in different ways for different people. Sometimes the impact of the cancer or treatment is short-term, allowing fertility to return after treatment. In other cases, the impact may be longer or even permanent.

Starting a family after cancer is possible, though treatment can sometimes affect your fertility. Whether or not to have a child after you’ve had cancer is a very personal decision. Having cancer may change the way you feel about having a child, and if you have a partner, it’s important to discuss your family plans together.

If you would like to have children in the future, talking to your medical team early will help you understand your options so you can take the steps required to protect your fertility before treatment begins.

Some people choose to preserve their fertility before treatment begins, for example freezing eggs, sperm or embryos, or using injections. However, fertility preservation can be expensive. Ask your fertility clinic about costs and treatment inclusions.

Your specialists can also guide you on the safest time to try for a baby, as you may need to wait between six months and two years after treatment before trying to conceive.

Research shows that fertility after cancer is generally safe, but there are some things to consider.

Most research indicates that having children after cancer treatment does not increase your risk of the cancer returning.

If you’re considering fertility after cancer and planning to have your first or another child, you might also wonder about passing cancer risk to your children. The good news is current research shows having a parent with cancer history does not increase a child’s cancer risk, above that of anyone else in the community.

While some cancers can run in families due to inherited genes (about 10% of cases), your healthcare team can help you understand fertility after cancer and manage any genetic risks. If you have been diagnosed with a cancer type that is deemed hereditary, your fertility specialist can discuss options like preimplantation genetic testing during IVF, which allows selection of embryos without cancer-risk genes.

If you would not like to have children after cancer treatment, your healthcare team can recommend the most suitable type of contraception for you.

Fertility options are different for people with different reproductive organs and also depend on whether you are about to begin cancer treatment or you have been treated in the past.

Talk to your fertility specialist about which options best suit your situation – they can help you understand risks, success rates, costs and timeframes for each approach.

For more information about fertility preservation or fertility after cancer, download our Fertility and Cancer fact sheet. It can be distressing learning about the impact of cancer and treatment on your fertility, for practical advice or emotional support, call the Cancer Council support line on 13 11 20.

Before you begin cancer treatment, there are a few ways to preserve and protect your fertility. It is important to let your specialist know you would like to preserve your fertility as early as possible.

Some people decide to freeze their eggs or embryos through IVF. In some cases, it is possible to freeze ovarian tissue or move the ovaries away from radiation treatment areas. Your fertility specialist might also suggest hormone treatments to protect your ovaries during chemotherapy.

After treatment, fertility options depend on several factors, including the type of treatment you had and whether you took steps to preserve fertility beforehand.

Before trying to conceive, yourself, your fertility specialist or reproductive endocrinologist may want to get some tests done to understand your fertility after cancer treatment.

Types of fertility tests include:

Some people can conceive naturally after treatment, while others might need assistance using their preserved eggs or embryos. If your ovaries are still working but conception is difficult, fertility treatments like IVF might help. You might also consider options like donor eggs or surrogacy.

Fertility options before you begin cancer treatment will depend on the type of cancer you have.

Sperm banking (cryopreservation) can be a simple and effective way to preserve your fertility. This involves freezing sperm samples for future use. For some people, it’s also possible to extract and freeze sperm directly from the testicles if needed. If you are receiving radiation treatment to the pelvic area, special shields can also be used to help protect the testicles.

Fertility options for people with testicles will depend on how the treatment affects sperm production. Some people can conceive naturally after treatment ends. If you stored sperm beforehand, it can be used with assisted reproductive treatments like IVF or Intrauterine insemination (IUI). If you’re not producing sperm after treatment, you might consider using donor sperm.

Some people can conceive naturally after treatment, while others might need assistance using their preserved eggs or embryos. If your ovaries are still working but conception is difficult, fertility treatments like IVF might help. You might also consider options like donor eggs or surrogacy.

After a cancer diagnosis, you may need to make decisions about your fertility. These decisions can be difficult, and you may feel that everything is happening too fast.

It can be helpful to:

• Take time to explore your options 
  Understanding all your options can help build confidence in your decisions. Talk with your healthcare team about each fertility option – they can walk you through the benefits, potential risks, costs and likely success rates for your situation. 
  
• Connect with others 
  Share your thoughts with people you trust, such as your partner, family member or friend. Fertility counsellors and psychologists are also trained to help you navigate fertility and cancer. Research shows that couples who make fertility decisions together are overall happier with the outcome, whatever it is. 
  
• Expect to experience doubts 
  It’s natural to feel unsure when making tough decisions. Some people find it helpful to track their thoughts and feelings in a journal or blog. Writing can help you process emotions and clarify what matters most to you. 
  
• Get extra guidance from a decision aid 
  Consider using decision aids – tools designed to help you weigh your options. These practical resources break down complex choices into clearer steps. For example, if you’re dealing with breast cancer, BCNA offers a helpful guide called Fertility-related choices. 

Cancer treatment can affect your ability to have children, but the impact on your fertility can be different for everyone and you do have options. While some treatments may cause temporary or permanent infertility, others won’t impact your fertility at all. Your healthcare team can help you understand your options before treatment begins. fertility before treatment begins.

Chemotherapy targets fast-growing cancer cells but can also affect reproductive cells, potentially damaging eggs in the ovaries, sperm production in the testicles or affect the heart and lungs — making future pregnancy and difficulty more difficult. These effects may be temporary or permanent, depending on the drugs used, dose and your age.

When treating cancers in the pelvic area, radiation therapy may affect your reproductive organs. While protective shields can sometimes help, the impact varies depending on the treatment area and dose.

Surgery to remove reproductive organs will affect fertility differently depending on what’s removed. While removing a single ovary or testicle may still allow natural conception, removing both leads to permanent infertility. For some early-stage cancers, fertility-sparing techniques might be possible.

Some cancers grow in response to natural hormones in your body and hormone therapy (also called endocrine therapy) works by reducing these hormone levels to slow or stop cancer growth. This treatment can temporarily affect fertility in different ways.

Some cancer treatments beyond standard chemotherapy and radiation can affect your fertility. Stem cell transplants for blood cancers require high-dose chemotherapy or total body radiation, which often leads to permanent fertility changes. For newer treatments like immunotherapy and targeted therapy, we’re still learning about their impact on fertility.

It’s important to talk to your cancer specialist about any fertility concerns before starting cancer treatment. They will explain the specific impacts of your treatment and discuss ways to protect your fertility where possible.

It can be distressing learning about the impact treatment has on your fertility. For more information about cancer and fertility, practical advice or emotional support, call our Cancer Council support line 13 11 20.

Some cancer treatments do not affect a child’s reproductive system while others can damage the ovaries or the testicles. Sometimes the damage is temporary, but sometimes it is permanent and can make it difficult or impossible to conceive later in life.

Most decisions about fertility preservation are made before treatment begins and involve the specialist, the young person and their parents or carers. Parents of children under 18 will usually need to consent to any fertility preservation procedures.

For more information about the ways to preserve fertility, download our 13 11 20.

Learning that cancer treatment has permanently affected your fertility can be deeply emotional, whether you planned to have children. You might experience a range of feelings – sadness about the changes to your body, anger about lost choices, anxiety about your future and more. These responses are completely normal, and support is available.

Many people find it helpful to talk with a counsellor or psychologist who understands the unique challenges of losing fertility after cancer. They can provide strategies to help you process these emotions and adjust to your changed circumstances.