Cancer Treatment and Ovarian Function

The Effects on Your Fertility

If you or your daughter are being treated for cancer, your first concern is to save your or your child’s life and health. That has to be your first priority! But something else to think about and to discuss with your oncologist if you or your child are still in your fertile years is the effect of cancer treatment on a woman’s fertility.The ovaries can be hurt by radiation or chemotherapy. Some treatments have been proven to damage ovaries and diminish the number of eggs you have, which is known as ovarian reserve. Sometimes the effects are temporary, and in other cases they are permanent.

How Cancer Treatments Affect a Woman’s Fertility

Fertility problems in women from cancer treatment occur in two ways, according to Cancer.net, the patient website of the American Society of Clinical Oncology: Damage to organs involved in reproduction, such as the ovaries, uterus, and cervix, and damage to organs that produce the hormones needed for reproduction, such as the ovaries. Damage to the ovaries may reduce a woman’s ovarian reserve. The loss of healthy eggs in the ovaries causes infertility and early menopause. Eggs can’t be regrown, so any reduction in the number of eggs a girl or woman has is permanent.

Cancer Treatments Which May Affect Your Fertility

There are several cancer treatments which have known or possible side effects. Surgical removal of any of the reproductive organs or of pelvic lymph nodes will affect fertility. Whole-body radiation therapy for stem cell or bone marrow transplants or radiation therapy to the areas where the reproductive organs are or to the pituitary gland in the brain may cause infertility. Several drugs used for chemotherapy, especially medications called alkylating agents, can affect fertility, according to Cancer.net, including busulfan (Busulfex, Myleran), carmustine (BiCNU), chlorambucil (Leukeran), cyclophosphamide (Neosar), doxorubicin, (Adriamycin), lomustine (CeeNU), mechlorethamine (Mustargen), melphalan (Alkeran), and procarbazine (Matulane).

What to Do If You’re Concerned

Children and younger women have a larger ovarian reserve than older women, so they are less likely to become infertile from cancer treatment. However, this really depends on the kind of treatment they have. With radiation and strong chemotherapy, even children can lose their fertility. After treatment your doctor may recommend that you wait some years before becoming pregnant, depending on the type and stage of cancer and the type of treatment you had. This waiting period can affect your fertility as well, because the number and quality of a woman’s eggs declines over time. If you have concerns about your own or a child’s fertility, it is best to talk to a reproductive endocrinologist about options to preserve fertility before cancer treatment begins. If you had radiation or chemotherapy in the past and want to become pregnant, a reproductive endocrinologist can assess your ovarian reserve and other factors that affect your ability to have a baby and advise you if assisted reproductive technology can help you. Fertility preservation before treatment begins, such as freezing embryos or eggs for future use, helps to keep your options open. But even if these treatments are not available or recommended for you, there may be other ways you can become a parent. Consult a fertility specialist and don’t give up hope.