Four Things You Must Know Before Cancer Treatment

Have you been diagnosed with cancer and are getting ready to start treatment? If you are in your fertile years, whether you’re a woman or a man, or you have a child who needs treatment, it’s important to understand if and how you can retain the ability to have a family.

What is Oncofertility?

Oncofertility is a relatively new field of medical research and practice that combines oncology, which deals with the prevention, diagnosis and treatment of cancer, and reproductive medicine. The aim of oncofertility is to treat cancer while preserving a patient’s fertility or keeping options open for reproduction in the future. The Oncofertility Consortium is a national initiative designed to explore the reproductive future of cancer survivors. They provide a website with educational resources for patients at myoncofertility.org.

How Does Cancer and Its Treatment Affect Fertility?

Some types of cancer directly affect your ability to have children. Uterine cancer and ovarian cancer in women damage those organs, while testicular cancer affects men’s fertility. However, treatment for many different kinds of cancer can harm a person’s fertility.
Chemotherapy can damage a woman’s eggs. The damage greatly depends upon the drug and the dosage used, according to the American Cancer Society. Chemotherapy may also affect fertility in men by stopping sperm production. Again, the drug used and its dosage have varying effects on a man’s fertility. The man’s age also plays a role. Men over 40 may not recover the ability to produce sperm after chemotherapy. Boys and young men who have chemotherapy may be able to recover the ability to produce sperm after a few years.

Radiation treatment can also affect fertility, even if the treatment is not aimed at the ovaries, uterus, or testicles. The radiation may bounce around inside your body and harm reproductive organs. Little is known about the effects of targeted and biologic (immune) therapies on the reproductive systems. These therapies are relatively new. Bone marrow or stem cell transplants almost always result in infertility, in both men and women. These therapies require high doses of chemotherapy and may also require radiation treatment.

When Should You Talk to Your Healthcare Team about Your Fertility?

If you are in your fertile years or you have a child who needs cancer treatment, talk to the care team before treatment begins. You have a right to know how treatment may affect your ability to have a family, or your child’s ability if he or she is the patient, and what steps can be taken to keep that option open. You may want to speak to a reproductive endocrinologist, who is a fertility expert, about ways you can protect your fertility before treatment and how you can have a family after treatment if your reproductive organs are damaged. Some reproductive endocrinologists have extensive experience with fertility preservation and can work with you and your oncologist before treatment if time permits.

What Can I Do If I’ve Already Been Treated for Cancer?

Many people are not told that their cancer treatment may affect their fertility, or they are overwhelmed by all the information about their condition and its treatment. If you have been treated for cancer and are having problems trying to conceive, consulting a reproductive endocrinologist will help you find out what your options are to have a family. These may include testicular sperm extraction (TSE), donor sperm, donor eggs, and IVF. Adoption may be another option to consider. Most adoption agencies do not rule out cancer survivors, but they may require a letter from your doctor stating that you are cancer-free and can expect to have a normal, healthy lifespan, according to the American Cancer Society.