The short answer
Some cancer treatments can lower fertility or cause infertility — changes that may be temporary or permanent. Whether your fertility is affected depends on the type and dose of treatment, your age, the type of cancer, and other factors. Because the most effective options to protect fertility usually happen before treatment, it helps to ask early.
Cancer treatments can cause infertility or lower fertility; changes may be temporary or permanent.
Whether fertility is affected depends on the treatment, dose, duration, your age, and other factors.
Chemotherapy, radiation, hormone therapy, surgery, stem cell transplant, and some other treatments can play a role.
The cancer itself sometimes affects fertility, even before treatment starts.
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The full explanation.
The simple version
Some cancer treatments can lower fertility — the ability to have children — or cause infertility. These changes may be temporary or permanent. Not everyone's fertility is affected, but many people are, so it is worth understanding your own situation early.
According to the National Cancer Institute (NCI), treatments can affect fertility by harming the reproductive organs and the endocrine glands that make the hormones fertility depends on.
What affects whether fertility changes
Whether your fertility is affected depends on several things:
- the type of cancer treatment or treatments
- the amount (dose) of treatment
- the length of treatment
- your age at the time of treatment
- how much time has passed since treatment
- the type of cancer and whether the tumor is near reproductive organs
- your fertility before treatment, including any past fertility problems
- other personal health conditions
Because so much depends on the details, two people with the same cancer can have very different outcomes.
Treatments that can play a role
NCI describes how different treatments may affect fertility:
- Chemotherapy can harm healthy reproductive cells as well as cancer cells. Some chemotherapy drugs, such as alkylating agents, carry a high risk. High doses or several drugs at once can raise the risk.
- Radiation therapy to the reproductive organs, the pelvic region, or the brain and central nervous system can affect fertility. The dose, the area treated, your age, and the type of radiation all matter.
- Hormone therapy (also called endocrine therapy) adds, blocks, or removes hormones and can affect fertility.
- Surgery on or near reproductive organs can affect fertility, depending on the type, size, and location of the tumor.
- Stem cell transplant often follows high doses of chemotherapy, radiation, or both, which can affect fertility.
- Targeted therapy and immunotherapy are still being studied. Some targeted drugs called tyrosine kinase inhibitors may lower fertility.
Ask your team what is known about the specific treatment you may receive.
The cancer itself can matter
Sometimes the cancer affects fertility before treatment even begins. For example, some people are found to have lower fertility at the time of diagnosis. Cancers that affect children, teens, and young adults — such as lymphoma, leukemia, and central nervous system tumors — are also linked with fertility problems.
Why timing matters
The most effective steps to protect fertility usually happen before treatment starts. NCI notes that research found survivors felt less regret when they had met with a fertility specialist first — whether or not they went on to preserve their fertility.
If having a biological child one day may matter to you, it helps to raise the topic early, even when time feels short. Ask about how your treatment could affect fertility, and ask for a referral to a fertility specialist to learn about your options.
Birth control during treatment
Even when treatment lowers fertility, pregnancy can still be possible, and some treatments can be harmful to a pregnancy. Because of this, your doctor may advise using birth control or condoms during treatment. Your care team can explain what is right for your situation.
Words to know
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Common questions
▸Do all cancer treatments affect fertility?
No. Whether fertility is affected depends on the specific treatment, the dose and length of treatment, your age, the type of cancer, and other personal factors. Some people's fertility is not affected.
▸Are the changes permanent?
They can be temporary or permanent, depending on the treatment and the person. Sometimes fertility returns after treatment; other times the change lasts. Your care team can explain what to expect for your treatment.
▸Which treatments can affect fertility?
The National Cancer Institute lists chemotherapy, radiation therapy, hormone therapy, surgery, stem cell transplant, and some targeted therapies and immunotherapies as treatments that may affect fertility. The effect depends on the details of the treatment.
▸Can the cancer itself affect fertility?
Yes. Some cancers, including certain reproductive, blood, and central nervous system cancers, can affect fertility even before treatment begins.
▸When should fertility be discussed?
As early as possible. The most effective steps to protect fertility usually happen before treatment starts, so raising it early keeps more options open.
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