Sex, fertility and acute myeloid leukaemia

There is no physical reason why having AML or its treatment should affect your sex life. But you will probably go through times when you don’t feel like sex because you are too tired, or have other side effects of treatment.

It is important to use contraception during treatment. Getting pregnant while you (or your partner) is having treatment is not a good idea, because the drugs might harm the baby.

Even if you are taking the pill, you should use barrier contraception to make sure your partner is safe. We don't think any of the drugs would get into your bodily fluids, but there is a small chance that they could, so the barrier contraception is to protect your partner.

There is more information about sex, sexuality and cancer in our coping with cancer section.

If you haven’t had children you may be worried about your fertility. Most of the treatments for AML are likely to make you infertile.

Permanent infertility is almost certain if you have intensive treatment, such as a bone marrow transplant or stem cell transplant. Your doctor will tell you if it is likely you will become infertile. If you have a partner, you may want to see your doctor together so that you can both discuss any fears or worries. Don’t be afraid to ask questions. Being well informed can help you cope. Below is information about 

• Women and infertility
• Men and infertility

Women and infertility

Chemotherapy can affect a woman’s fertility by stopping the ovaries from producing eggs. If this happens, you won’t be able to become pregnant and may have symptoms of the menopause. If you have an early menopause, your doctor may offer you hormone replacement therapy (HRT) to reduce menopausal symptoms. HRT replaces the hormones you would normally produce – oestrogen and progesterone. Having HRT doesn’t mean you will produce eggs but you may still have a period each month. HRT can also help to prevent longer term problems like thinning of the bones (osteoporosis) and heart disease.

You take HRT as a tablet or can have a skin patch, like a plaster (bandaid). The dose of hormones is lower than you would normally produce if you had not had an early menopause. So you are very unlikely to have any side effects.

Radiotherapy can also affect your fertility, this includes total body irradiation. Even small doses of radiotherapy to the ovaries can stop them producing eggs. Radiotherapy can also affect the womb so that it is unable to support a baby.

Remember, it is important to use contraception during treatment. Getting pregnant while you (or your partner) is having treatment is not a good idea, because the drugs might harm the baby.

Men and infertility

Chemotherapy can affect a man’s fertility by

• Reducing the number of sperm you make
• Affecting the ability of the sperm to fertilise an egg

This may be temporary or may mean you can no longer father a child.

Radiotherapy can also affect fertility so that you can no longer produce sperm.

Unfortunately, treatment for AML often has to start very quickly, so it is not usually possible to bank sperm beforehand.

Doctors are researching new treatments that aim to reduce the risk of infertility, but still cure the leukaemia. A study in 2006 looked at the effect of a stem cell transplant on men’s sperm. It found that a small number of the men started producing sperm again, especially if they were under 25 years of age. This is promising but we need more research, as it is not certain that this meant that they would be able to father a child.

Remember it is important to use contraception during treatment. Fathering a child during treatment may affect the baby. If you don’t want to have a baby, you should continue to use contraception after treatment until you know for certain that you are infertile.

You can find more information about fertility in the following sections of this website

• Fertility and chemotherapy
• General side effects of radiotherapy

It can be extremely distressing to find out that your leukaemia treatment will stop you being able to have children. It can seem very unfair to have to cope with this as well as your leukaemia. Even if you hadn’t thought about having children before, losing your fertility can be very difficult to cope with. It can also affect how you feel about yourself.

It takes time to adjust. You need to give yourself time to come to terms with it. Talking to someone close to you is usually helpful, although you may not be able to do this for a while.

You may want to talk to someone other than your partner or family members. You may find that it helps to speak to a counsellor or a therapist. Your doctor or nurse can put you in touch with professional help if you would like it. Don’t be afraid to ask, as it really can help.

If you would like to talk to someone outside your own friends and family, contact one of the organisations on the counselling organisations page. To find out more about counselling, look at the counselling section.