Receiving a diagnosis of cancer can be overwhelming, and one of the concerns many people have is whether their cancer treatment will have long-term effects on their fertility.

While cancer treatment has undoubtedly advanced in recent years, it’s important to understand that certain treatments can indeed affect fertility in both males and females. In this article, we will explore how different cancer treatments can impact your reproductive potential and what options are available to preserve fertility.

Radiation therapy and fertility

Radiation therapy, which uses high-energy radiation to destroy cancer cells, can have a direct impact on fertility depending on the area being treated.

If the radiation field includes the reproductive organs, such as the ovaries, uterus, or testicles, there is a high likelihood of fertility impairment.

Female fertility: In females, radiation therapy to the pelvis can lead to damage to the ovaries, resulting in decreased ovarian function and premature menopause.

This can cause a significant decline in fertility or even permanent infertility. The risk and degree of damage depend on the radiation dose received and the age at the time of treatment. Younger women may have a higher chance of retaining some ovarian function compared to older women.

Male fertility: Radiation therapy to the testicles can affect sperm production and quality. The severity of the impact depends on the radiation dose, the volume of testicles irradiated, and the age at the time of treatment.

It’s important to note that fertility may recover partially or fully within two years after radiation treatment, but permanent infertility is also possible.

Chemotherapy and fertility

Chemotherapy, the use of drugs to kill cancer cells, can also affect fertility. Different drugs have varying effects, and the risk of fertility impairment depends on the specific chemotherapy regimen and dosage.

Below are the potential effects on fertility for both males and females:.

Female fertility: Some chemotherapy drugs can cause damage to the ovaries and reduce ovarian reserve. This can result in temporary or permanent infertility, as well as early menopause.

The risk of infertility is higher with higher cumulative doses of chemotherapy.

Male fertility: Chemotherapy drugs can impair sperm production and quality, leading to temporary or permanent infertility.

The impact on fertility depends on the specific drugs, cumulative dosage, and the man’s age at the time of treatment. Similar to radiation therapy, sperm production may recover within a couple of years after completing chemotherapy.

Surgical interventions and fertility

Surgery is a common approach to treat many types of cancer. While surgical interventions themselves do not directly impact fertility, certain procedures can inadvertently damage reproductive organs or disrupt their normal function.

Notable examples include:.

Hysterectomy: Removal of the uterus can cause permanent infertility in females, regardless of whether the ovaries are preserved or removed.

If fertility preservation is a concern, it’s crucial to discuss the possibility of preserving the uterus or obtaining eggs prior to the surgery.

Bilateral oophorectomy: The surgical removal of both ovaries in females results in immediate permanent infertility.

It’s important to discuss fertility preservation options before undergoing this procedure, especially for patients at risk of ovarian cancer or with specific types of breast cancer.

Orchiectomy: Removal of one or both testicles can result in infertility in males. The impact on fertility depends on the remaining testicle’s functionality and hormone production ability.

Preserving sperm prior to the surgery should be considered for patients desiring future fertility.

Fertility preservation options

If preserving fertility is a concern, it is essential to explore options before starting cancer treatment. Here are some common fertility preservation methods:.

Egg freezing: Also known as oocyte cryopreservation, this technique involves extracting a woman’s eggs, freezing them, and storing them for future use.

Egg freezing offers an opportunity for women to preserve their fertility and increase the chances of conceiving after cancer treatment.

Sperm banking: Males can provide a semen sample that is analyzed, processed, and frozen. The frozen sperm can be used for future assisted reproductive techniques, such as in vitro fertilization (IVF).

Embryo cryopreservation: This option involves fertilizing eggs with sperm to form embryos, which are then frozen and stored.

Embryo cryopreservation requires a male partner or donor sperm and is typically not suitable for individuals without a sperm source.

Ovarian tissue cryopreservation: In some cases, ovarian tissue can be surgically removed and cryopreserved for future transplantation. This option is still considered experimental and requires specialized centers.

Preimplantation genetic testing: Prior to embryo transfer, preimplantation genetic testing (PGT) can be performed to screen embryos for genetic abnormalities and increase the chances of a healthy pregnancy post-cancer treatment.

Discussing fertility preservation with your healthcare team

It is crucial to have an open and honest conversation about your fertility concerns with your oncologist and a reproductive specialist prior to initiating cancer treatment.

Discussing the potential risks, available options, and the timing of fertility preservation procedures is essential for making informed decisions. Consider asking the following questions:.

What are the risks of this cancer treatment on my fertility?
Are there any specific fertility preservation options suitable for my situation?
How do I proceed with fertility preservation, and when should I start?
What are the costs associated with fertility preservation?
Are there any support services available to cope with the emotional challenges of fertility-related decisions?

Conclusion

Cancer treatment can indeed impact fertility, but there are options available to preserve reproductive potential.

It is essential to discuss fertility preservation with your healthcare team before starting treatment to explore suitable options based on your specific situation. By being proactive and well-informed, individuals can make choices that align with their future reproductive goals and improve their chances of creating a family.