About fertility and chemotherapy

Some chemo drugs cause infertility. Infertility means that you can't have children. It may be temporary or permanent, depending on the drugs you have, your age and other factors. Many people go on to have healthy children after chemotherapy treatment. But some chemotherapy drugs can cause permanent infertility, especially in high doses.

It is important to discuss the risk of infertility with your doctor before you start your treatment. If you have a partner they will probably want to join in during the discussion. Then you both learn all the facts and have the chance to talk over your feelings and choices for the future.

Men having chemotherapy may want to consider sperm banking before starting treatment. The sperm can later be used as part of fertility treatment to father a child.

Researchers are looking into removing ovarian tissue, freezing it before chemotherapy starts and later putting the tissue back so that women can regain their fertility after chemotherapy. This is still experimental at the moment, and so is not widely available. But if you are interested, you could talk to your specialist about it. You may be able to take part in some of the research. Women who have a partner can have fertilised eggs (embryos) frozen for use in later fertility treatment. It is also sometimes now possible for women to have unfertilised eggs frozen. The fertilisation rates for these is low, but is improving as researchers develop better techniques. There is more about how women can keep their fertility in this section of CancerHelp UK.

Infertility can be very hard to come to terms with. People are different in their reaction to infertility

• It can feel devastating if you wanted to have a child or wanted more children to complete your family
• Some people seem to accept it and feel that beating cancer is more important
• Others seem to accept the news calmly when they start treatment, but find it hits them later when the treatment is over

Many people feel anxious, afraid or depressed about

• Having cancer
• Needing chemotherapy
• The effect that both of these have on their lives

These feelings can start with something small, such as having to change your daily routine to fit in with the treatments. Or something more obvious, such as the side effects of the treatment, or the risk of infertility.

If you feel low or worried it can help to know that you're not alone. Many cancer patients have felt as you do at some time during their treatment. Like them, you can overcome feeling afraid or discouraged.

You may feel you have lost a part of yourself and are less masculine or less feminine if you can't have children. You may be very sad or angry that the drugs cause changes to your body and your self confidence can be affected. It can help to talk to someone such as a close friend or relative. If you would prefer to talk to someone outside your normal life, ask your chemotherapy nurse about counselling and support groups available at your hospital or in your area. You can also look in the counselling section for information about finding a counsellor.

CancerHelp UK has a section about your emotions. You and your partner may wish to speak to a therapist or counsellor specialising in fertility problems. Speak to your doctor or clinical nurse specialist or check the general organisations list for organisations that can help put you in touch with a support group.

You may find books in the general reading list useful. Some of these books are written by patients. They may be useful in helping you to come to terms with infertility and other problems of chemotherapy. Other patients who have coped with infertility can give you support and ideas. Just speaking with other people who have gone through similar things can be a great comfort – you realise you are not alone.

It is possible for a woman having chemotherapy, or the female partner of a man having chemotherapy, to get pregnant during treatment. So it's very important to avoid pregnancy during chemotherapy and for a while afterwards as the drugs could harm the developing baby. Use reliable contraception. If you are a woman being treated, and have been taking the contraceptive pill, then check with your doctor whether it is alright for you to continue. In some people the pill can make you slightly more at risk of having a blood clot (thrombosis). If you can use it, the pill is a very reliable form of contraception. Barrier methods may be safest if you have a risk of blood clots, for example

• Condoms
• The cap

We do not think that your chemotherapy treatment will affect your partner. But there is a small chance that the drug could find its way into your body fluids. Doctors don't know for sure, so they advise using barrier contraception (condom) during a course of chemotherapy and for a week or so afterwards. This applies whether it is the man or the woman being treated.