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Childhood cancer survivors may worry that the treatment they received will affect their ability to have children.
Infertility can be a side effect of certain cancer treatments. Infertility is the inability to achieve a pregnancy after a year or more of regular sexual intercourse without using any birth control methods.
Radiation and surgery to specific parts of the body and certain chemotherapy drugs may have an impact on 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.
There are some treatments for infertility.
Some survivors may mistakenly think they are not able to get pregnant. This assumption can lead to unintended consequences.
Alkylating agents and similar chemotherapy drugs can cause problems with fertility:
It is not yet known if newer treatments such as immunotherapy and targeted therapies have any effects on fertility.
Radiation therapy to the pelvic area can have an impact on fertility. It can harm 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 affect a woman’s ability to carry a pregnancy.
Surgical procedures that affect reproductive organs can have an impact on fertility.
Treatment to the region of the brain that contains the hypothalamus and pituitary gland can affect hormone production that regulates sperm and egg development.
But each case 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.
Survivors are encouraged to talk to their care provider about whether to consider fertility testing. Having this knowledge can help people make decisions about family planning.
Screening may start 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 blood. 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 start 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.
These tests may include:
Survivors who are interested in knowing more about their fertility should consider talking to their health care provider. They may be eligible for fertility preservation options such as egg or sperm banking.
There are several family planning options for survivors who are infertile or who have trouble carrying a pregnancy.
Survivors are encouraged to discuss 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 about financial support resources.
Reviewed: June 2020