Fertility and family planning

Making decisions about your cancer treatment can mean having some conversations about fertility and family planning. This can be overwhelming – especially if having children is something you have never really thought about before. For some, having cancer treatment means making these decisions sooner than expected.¹

We know that these conversations and decisions are important.² So, to help, we’ve put together some information to guide you through how cancer treatment can affect fertility, what you should consider before starting treatment, and how to discuss these issues with your healthcare team.

Understanding fertility and cancer treatment

Some cancer treatments, like chemotherapy, radiation, and some surgeries, can have a negative impact on fertility.² They might affect the number of eggs in the ovaries¹ or reduce the amount of sperm that is produced.³ Each treatment has its own risks, so it’s important to talk to your doctor before beginning any treatment. 

Things to think about before treatment begins

Before you start your treatment, it's important to take a bit of time to think about these possible side effects. If having children is something you think you may want to do, or continue to do after treatment, there are several options to explore when it comes to preserving your fertility.^2,3 

These include:³

• Freezing eggs – a process where the eggs are collected, frozen, and stored to be used later to have a child
• Freezing embryos – this involves fertilising collected eggs with sperm from a partner or from a donor in a lab. If the fertilised eggs develop into embryos, they are frozen and stored
• Storing sperm – sperm is collected and stored, ready to use later to have a child

Timing is important when it comes to fertility preservation, so aim to have these conversations with your healthcare team as soon as possible. They can help you understand how your treatment might affect your fertility and explore the best options to preserve it for the future.²

In the UK, funding for freezing and storing eggs and embryos can be provided by the NHS. However, things can vary depending on where you are in the country, as different areas have different criteria. Sometimes, you may have to pay to keep storing eggs, embryos, or sperm after a number of years.⁴

Contraception while having treatment

Some cancer treatments can cause harm to an unborn baby or can increase the risk of miscarriage. For this reason, you should not become pregnant or get someone else pregnant while you are having cancer treatment.⁵ 

The type of contraception that is best for you and your partner can vary depending on the treatment you are having. For example, some people will be advised to use a barrier method of contraception, such as condoms. Whereas some people with hormone-dependent cancers should avoid hormone-based contraceptives like the pill.⁵ 

Speak to your healthcare team about which methods of contraception are best for you. 

Early menopause

Some cancer treatments can trigger an early menopause. If this happens, your periods become irregular and eventually stop completely.⁶ 

You may also have some of these symptoms:⁶

• hot flushes
• dry skin
• vaginal dryness
• loss of energy
• less interest in sex
• mood swings
• feeling low

There are treatments and options that your healthcare team may be able to offer, to help manage and cope with the symptoms and side effects of menopause. Your doctor may prescribe hormone replacement therapy (HRT) when you finish your cancer treatment. HRT can reduce symptoms of the menopause, but it can’t reverse the infertility that comes with menopause.⁶

Fertility after cancer treatment

It can be hard to predict if, how, or when your fertility will recover after you stop your treatment. Most doctors will recommend that you wait a little while after you finish your treatment before trying to have a baby.¹

Before you start, you may want to have fertility tests to get some more information. The decision to try to have a baby is a big one. After cancer treatment, you might have new questions or concerns about your fertility that you didn’t think about before. When you feel ready, you can talk to your doctor for more guidance and support.¹

Exploring other options

If the decision to have children is taken out of your hands, it is important to know that there are many other options that you can explore to bring parenthood to you. Adoption, surrogacy and sperm or egg donations are all examples of other family planning options.¹ If you would like more information about the other family planning options that are available to you, please speak to your doctor for guidance and support.

Learning how cancer and its treatment may affect your fertility can be overwhelming, but understanding and exploring your options can help you to feel supported and prepared for any outcome. It’s important that you are able to talk openly with your healthcare team. They are there to provide you with the reassurance, information, and guidance that you need.