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Fertility After Childhood Cancer: Can I Have Children?

If you had cancer as a child or teen, you might wonder: Will I be able to have children someday? This ability to have children is called fertility. 

Some cancer treatments—like certain chemotherapy (chemo) drugs, radiation, or surgery—can make it harder to get pregnant or father a child.  

Infertility means trying to get pregnant with a partner for at least one year without using birth control and not becoming pregnant. But that does not mean pregnancy is impossible. Everyone’s situation is different. 

For females, some treatments can also make carrying a pregnancy more difficult. And some survivors may go through menopause earlier than usual. Menopause means periods stop, and pregnancy is not possible anymore.

Possible fertility outcomes after cancer treatment

Cancer survivors can have different fertility outcomes after treatment. These include: 

  • Normal fertility: You can get pregnant or father a child. 
  • Shorter fertility window: You may have fewer years to get pregnant or father a child. 
  • Harder to get pregnant: It may take longer to become pregnant, or you may need medical help. 
  • Trouble carrying a pregnancy: You may need extra care during pregnancy. 
  • Sterility: You are unable to have a biological child. 

Don't assume you can't get pregnant

Some cancer patients and survivors think they cannot have kids and skip birth control. That can lead to surprises. If you are sexually active and not planning a family, use birth control. And always use condoms to prevent sexually transmitted infections (STIs). 

Cancer treatments that may affect fertility 

Treatments that can affect fertility include:

Chemo drugs

Some chemotherapy medicines are more likely to affect fertility. These may include:

Alkylating Drugs
 Heavy  Metal Drugs
Non-classical alkylators

Radiation

Radiation to the pelvic area can affect fertility.  

In females, pelvic radiation can harm reproductive organs. It can also reduce the number and quality of eggs in the ovaries that help form a baby. Radiation therapy to the pelvic and abdominal (belly) area may also affect the ability to carry a pregnancy. 

In males, pelvic radiation can harm the testes and reduce the number and quality of sperm that help form a baby. 

Surgery

Surgery can affect fertility if it involves reproductive organs or parts of the body that control hormones. Surgery in the pelvis or abdomen could also cause scar tissue that affects future fertility. 

Brain treatments

Radiation or surgery near the hypothalamus or pituitary gland in the brain can affect hormones that control puberty and fertility, including sperm and egg development. 

New cancer treatments

It is not clear if newer treatments like immunotherapy and targeted therapy affect fertility. Always discuss risks with your care team. 

Knowing your treatment history can help you understand your risk and make informed choices, including whether fertility testing is right for you.  

  1. Fertility testing for female cancer survivors

    Screening may start with a physical exam and medical history. Your health care provider will ask about body development and menstrual history. They will do a breast exam, a pelvic exam, and blood tests to look at overall health. 

    Your provider may check hormone levels in your blood. These may include:  

    • Follicle-stimulating hormone (FSH): FSH helps egg production and a hormone called estradiol.  
    • Estradiol (estrogen): Estradiol is a form of estrogen. Estrogen helps develop and maintain female sex characteristics. 
    • Luteinizing hormone (LH): In women, LH causes the ovaries to release an egg during ovulation. 
    • Progesterone: This hormone helps regulate the menstrual cycle and prepares the body for pregnancy. 
    • Anti-Müllerian hormone (AMH): Levels of AMH can help determine the quantity and quality of a female’s remaining egg supply. AMH levels usually start to drop after puberty and throughout adulthood until they reach menopause. 

    In some cases, your provider may recommend further testing. These tests may include imaging tests to examine the ovaries, fallopian tubes, and uterus. 

    Read more about fertility and reproductive health in females.  

  2. Fertility testing for male cancer survivors

    Screening may start with a physical exam and medical history. Your health care provider may order a semen test and blood tests to measure the level of certain hormones in the blood. 

    Semen analysis: Semen is the bodily fluid in men that contains sperm. A semen analysis, also called a sperm count, measures the quantity and quality of sperm. Results of the analysis include: 

    • Volume: Amount of semen 
    • Sperm count: Number of sperm per milliliter 
    • Sperm movement: How active the sperm is 
    • Sperm shape: Abnormal shape can affect fertility 
    • White blood cells: May be a sign of an infection 

    Hormone tests: Your health care provider may order blood tests to measure the level of certain hormones, such as: 

    • Testosterone: This hormone helps sperm production and causes physical changes in males. These changes include the development of sex organs, deepening of voice, growth of facial and body hair, and muscle development. Low testosterone can lead to low sperm counts or unhealthy sperm. 
    • Follicle-stimulating hormone (FSH): High or low levels of FSH may indicate problems with sperm production or other hormones. 
    • Luteinizing hormone (LH): This hormone signals the testes to make testosterone. 
    • Prolactin: If prolactin is too high, it can affect testosterone levels. 
    • Estradiol (estrogen): Normally low in males, high levels can affect testosterone and fertility.  

    If any of these results are abnormal, your provider may order more tests. 

    Read more about fertility problems and reproductive health in males.

What if I have questions about my fertility?

Talk with your health care provider if you have questions about your reproductive health after cancer. They can refer you to a fertility specialist who can explain treatment options and recommend information and support resources. 

If you have been recently diagnosed with cancer, talk with your care team about fertility preservation options. To learn more, visit:    

Questions to ask your care team 

  • Could my cancer or cancer treatments affect my ability to have children now or in the future?  
  • Which of my treatments could affect fertility? 
  • Who can I talk to about my fertility? 
  • What fertility tests do you recommend for me?  
  • If I don’t want to do fertility testing now, can I change my mind later? 
  • What do my test results mean for my chances of having children in the future? 
  • Could my fertility change as I get older?  
  • If I want children someday, are there options or plans I should think about now?  
  • Should I see a fertility specialist or reproductive health doctor? 
  • What can I do to take care of my body and sexual health? 

What to know about fertility in childhood cancer survivors

  • Some cancer treatments can affect fertility, but it does not always mean you cannot have children. Everyone’s situation is different.  
  • Some cancer treatments – including certain types of chemotherapy, radiation, or surgery – can affect the ovaries, testes, or hormones. 
  • Use birth control if you are sexually active and not planning a family. Do not assume pregnancy is not possible.  
  • Know your treatment history and talk to your care team about fertility and reproductive health. They can explain your risk, recommend testing, and refer you to a fertility specialist if needed. 
  • Fertility testing may include blood tests to check hormones and, for males, a semen analysis.   
  • If you have questions about fertility or sexual health, ask your care team. They can guide you on family planning, birth control, infertility risk, fertility preservation, and other important topics about reproductive health. 

—
Reviewed: April 2026

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