Infertility in Female Childhood Cancer Patients

Infertility can be a side effect of certain childhood cancer treatments. Infertility is the inability to produce children after a year or more of regular sexual intercourse without using any birth control methods.

Before therapy starts, families are encouraged to discuss the impact of treatment on the patient’s fertility or future ability to become pregnant and give birth. The pediatric cancer center may also have a fertility specialist who can consult with the family.

The organs of the female reproductive system work together so a woman can get pregnant, carry a developing human until time for delivery, and give birth.

The organs of the female reproductive system work together so a woman can get pregnant, carry a developing human until time for delivery, and give birth.

How the Female Reproductive System Works

To understand fertility, it’s helpful to understand how the reproductive system works. Females have two ovaries. They are located in a woman’s pelvic area.

During puberty, the pituitary gland in the brain signals the ovaries to start making more estrogen and progesterone. These are hormones necessary for the reproductive system to work.

A girl is born with all the eggs she will ever have. Once a month, the ovaries usually release one egg. If sperm from a male fertilizes the egg, the female becomes pregnant.

The organs of the female reproductive system work together so a woman can get pregnant, carry a developing human until time for delivery, and give birth.

How Cancer Treatment Affects Fertility in Females

Treatment that affects a patient’s pelvic area, reproductive organs, and pituitary gland may have an impact on a patient’s fertility. The treatment may decrease the number of eggs or affect the quality of the eggs.

Take Action Before Treatment Starts

Before treatment begins, parents and the patient, if old enough, should talk with the care team about the effect cancer treatment could have on the patient’s ability to have children.

  • If the treatment could affect fertility, ask the medical team what actions can be taken to protect fertility.
  • Find out the cost of treatments and if it is covered by insurance. Ask a social worker at your center for information about financial support resources.
Will treatment affect fertility? Ask the medical team what actions can be taken to protect it.
How much do the fertility preservation treatments cost? Are they covered by insurance? Ask a social worker at your care center about financial resources.

Procedures That Can Preserve Fertility

Questions to Ask Before Treatment Begins

Consider asking questions such as:

  • Could treatment increase the risk of, or cause, infertility?
  • Are there other recommended cancer treatments that might not cause fertility problems?
  • Which fertility preservation options would you advise for me?
  • What fertility preservation options are available at this hospital? At a fertility clinic?
  • Would you recommend a fertility specialist (such as a reproductive endocrinologist) that I could talk with to learn more?
  • Is birth control also recommended?
  • What are the chances that my fertility will return after treatment?
Could treatment increase the risk of, or cause, infertility?
Are there other recommended cancer treatments that might not cause fertility problems?
Which fertility preservation options would you advise for me?
Which fertility preservation options are available at this hospital? At a fertility clinic?
Would you recommend a fertility specialist (such as a reproductive endocrinologist) that I could talk with to learn more?
Is birth control also recommended?
What are the changes that my fertility will return after treatment?


Reviewed: July 2020