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Childhood cancer survivors may worry that the treatment they received will affect their ability to have children.
Radiation and surgery to specific parts of the body and certain chemotherapy drugs may affect a person’s fertility. Certain treatments may also affect a woman’s ability to carry a pregnancy.
Female cancer survivors may be at risk for early menopause. Menopause refers to the time in a woman’s life when she stops having a menstrual period and is no longer fertile. After menopause women no longer mature and release eggs.
Drugs known as alkylating agents and other chemotherapy can cause problems with fertility:
Radiation therapy to the pelvic area can have an impact on fertility. It can damage reproductive organs as well as reduce the number and quality of a woman’s eggs or a man’s sperm.
Radiation therapy to the pelvic and abdominal area may also have an effect on a woman’s ability to carry a pregnancy.
Surgical procedures that affect reproductive organs can affect fertility. Surgery to the abdominal and pelvic area may affect a woman’s ability to carry a pregnancy.
Treatment to the region of the brain that contains the hypothalamus and pituitary gland can have an impact on fertility because it could affect hormone production.
But every case and every person is different. Having these therapies does not automatically mean the affected person will not be able to have children.
Knowing your treatment history can help prepare you to make informed choices in the future.
For example, survivors are encouraged to talk to their care provider about whether or not to consider fertility testing. Having this knowledge can help people make decisions about family planning.
Screening may begin with a physical exam, including a pelvic exam or pelvic ultrasound, and blood tests to look at overall health. The provider will also order tests to measure the level of certain hormones in the bloods. These hormone tests may include:
In some cases, the provider may recommend further testing.
These tests may include imaging studies to examine the fallopian tubes and uterus:
Screening may begin with a physical exam and medical history.
The provider may order a semen test and blood tests to measure the level of certain hormones in the blood, such as testosterone, follicle-stimulating hormone (FSH), thyroid, and prolactin.
Semen is the bodily fluid in men that contains sperm. A pregnancy happens when sperm from a man and an egg from a woman unite. A semen analysis, also called a sperm count, measures the quantity and quality of a man's semen and sperm.
Results of the analysis include:
If any of these results is not normal, the provider may order more tests.
Read more about other fertility tests
Survivors who are interested in knowing more about their fertility should consider talking to their health care provider about their risk and may be eligible for fertility preservation options such as egg or sperm banking.
Survivors who are no longer fertile or may have difficulty carrying a pregnancy are encouraged to discuss other family planning options with their health care provider. These options may include:
Fertility options can be expensive and often are not covered by insurance. Survivors are encouraged to talk with a social worker at their survivorship clinic or through their primary care provider.
There are also organizations who may have resources to help you:
Some survivors may mistakenly assume they are infertile. This assumption can lead to unintended consequences.