There is a lot to think about when you are first diagnosed. You might be making decisions about your treatment plan, going to tons of new appointments, and wondering how to find a new “normal”—which is anything but normal! You might be worried about possible side effects and how your illness and treatments might affect you now and in the future.
One of the things that people might be asking you to think about is your fertility. The point of this resource is to help make talking about fertility, having kids, and how you are feeling a little bit easier.
Not everything in this resource will relate to your story. Some options won’t make sense for your treatment journey. But learning about your options can help you make a plan that is right for you.
Fertility is the body’s ability to make babies. In females, fertility is about the ability to get pregnant and carry a baby. When you can’t make a baby because something interferes with your reproductive system, this is called infertility.
Your treatment or other medical condition might affect your reproductive system and how your body works. Fertility preservation is the process of taking steps to protect your fertility so that you may have a better chance of having babies in the future.
Female reproductive system
To understand fertility, it’s helpful to know how the reproductive system works. You’ve probably heard about your reproductive system before. Maybe you talked about it with someone, or it might have come up in school. Even if you don’t want to have kids one day, your reproductive system is still really important to the way that your body works.
Maybe you know all of this already. In case you don’t, here’s a quick review of the reproductive system.
Parts of your reproductive system
The female reproductive system is made up of the vagina, cervix, ovaries, fallopian tubes, and uterus.
- Uterus: The uterus is a hollow muscular organ in the lower abdomen that holds a developing baby during a pregnancy.
- Vagina: The vagina is a muscular canal that goes from the uterus to the outside of the body.
- Cervix: The cervix is the narrow end of the uterus that connects to the vagina.
- Ovaries: The ovaries contain and release eggs and make hormones. They are located on either side of the uterus in the lower abdomen.
- Fallopian tubes: The fallopian tubes are a pair of narrow tubes that make a path between the ovary and uterus.
The brain also plays an important role in your reproductive system. The hypothalamus and pituitary gland are small structures in the brain. They help control the reproductive system by releasing hormones, or chemical messages, which tell the body when to grow, develop, and reproduce.
Puberty is the stage in life when you begin to have hormonal and physical changes associated with adulthood. The age at which this happens is different for each person, but it usually starts between ages 8 and 14.
During puberty, the hypothalamus and the pituitary gland signal the ovaries to start making more estrogen and progesterone. Your reproductive system needs these hormones so that it can work.
After puberty, you will start having menstrual cycles. During your menstrual cycle, the lining of the uterus thickens to prepare the body for a pregnancy.
The menstrual cycle is a monthly hormonal cycle, from the start of one menstrual period to the start of the next. About once a month, your ovaries usually release one egg, which travels through the fallopian tube to the uterus. This is called ovulation. Pregnancy can occur if an egg meets a sperm after sexual intercourse. The fertilized egg travels to the uterus, where it starts growing into a baby.
If you are not pregnant, your body will get rid of the lining of your uterus because it is not needed. Blood, tissue, and other fluids pass out of the body through your vagina. This is your menstrual period. If you are pregnant, hormones pause the monthly menstrual cycle so you don’t have periods.
The average menstrual cycle is about 28 days. However, there are many reasons that you might not have regular monthly periods. These include:
- Normal variations in cycle length
- Irregular periods at the beginning of puberty
- Contraceptive use, such as oral birth control pills or intrauterine devices (IUDs)
- Poor nutrition, excessive exercise, or stress
- Medical conditions such as polycystic ovarian syndrome (PCOS), diabetes, or thyroid disorders
A healthy reproductive system is important for your ability to have children. You were born with all the eggs you will ever have. The number of eggs that you have decreases as you get older and with each menstrual cycle.
Your fertility depends on many factors including your age, the number and quality of your eggs, how well your hormones work, and the health of your reproductive organs.
So what does this mean for me?
Your illness or its treatment might make it hard for your reproductive system to work properly. This can result in one or more fertility problems, such as:
- You may have a decrease in the number or quality of your eggs.
- You may have hormone changes that affect your ovaries, uterus, or reproductive cycle.
- Your uterus may not allow an egg to implant or carry a baby through a full pregnancy.
Some changes in your reproductive system may be short-term and go away after treatment. Other changes can be long-term and can cause infertility. It is important to talk to your care team about how your illness and treatments might affect your future ability to get pregnant and have a baby.
This helps give you as many choices as possible about how to have kids in the future. After learning about your options and talking with your care team, you may decide to take steps to preserve your fertility in case you want to have kids one day.
What are some possible fertility preservation options?
The options available to preserve your fertility depend on many factors, including your age and past and future treatments. Doctors and researchers are studying different fertility preservation options, including hormone therapies.
Talk to your care team if you have any questions about how the procedures work and what they mean for your ability to have children in the future.
What are some other options for having a baby later?
Sometimes, fertility preservation isn’t a good fit or there is not time due to the need for therapy. There are many ways to build a family after treatment. There is a chance your treatment will not affect your ability to have children. If so, you might naturally get pregnant and have a child.
If you still want to have kids, you have a few other choices, such as:
- Adoption
- Using an egg from another woman (egg donor)
- Having another woman (surrogate) carry and give birth to your baby
- Using an embryo created by 2 other people (embryo adoption)
You might also decide that you do not want kids, now or ever. That’s totally fine—lots of people feel that way.
Only you know what you want, and you get to make choices about that.
There are many ways to create a family. Your care team can help you learn about your options for having children after treatment. They want to help you make the best choice for you.
