Decorative image

Sex, fertility and ALL

Having acute lymphoblastic leukaemia (ALL) and its treatment might affect your sex life and if you are able to have children in the future (your fertility). Find out more.

Your sex life and ALL

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

It's important to use contraception during treatment. It is not advisable to become pregnant while you (or your partner) are having treatment because the drugs might harm the developing baby.

Doctors usually advise that you use barrier contraception (such as condoms or femidoms) during treatment, even if you or your partner is taking the contraceptive pill. It is not known for sure whether or not small amounts of chemotherapy drugs can be passed on through semen or secretions from the vagina. Generally, doctors advise using the barrier method for the time you are actually having the treatment and for about a week afterwards.

Fertility after ALL treatment

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

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. 

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.

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

There are ways for women to try to keep their fertility, such as freezing eggs. But unfortunately it isn't usually possible to do this for ALL as treatment often needs to start quickly after diagnosis. Talk to your doctor or nurse about any concerns you may have about your fertility. 

Your doctor can treat early menopause with hormone replacement therapy (HRT) or a combined hormonal contraceptive. This helps reduce menopausal symptoms and replaces the hormones you would normally produce - oestrogen and progesterone.

You and your doctor will decide together which is the best for you. HRT and the combined hormonal contraceptive helps in preventing long term problems due to the menopause like thinning of the bones (osteoporosis).

You take HRT as a tablet or you can have a skin patch, like a plaster. There are common side effects that you might get from HRT like headaches, feeling sick, tiredness, and breast pain and tenderness. 

The combined hormone contraceptive comes as a tablet, skin patch or as a ring that you put inside your vagina.  This also comes with common side effects such as headaches, feeling sick, changes in mood, breast pain and tenderness, and weight gain. 

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

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

Unfortunately treatment for ALL often has to start very quickly, so it isn't always possible to bank sperm beforehand.

Remember it is important to use contraception during treatment. Becoming pregnant or 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.

Coping with infertility

It can be extremely distressing to find out that your leukaemia treatment could stop you being able to have children. It can seem very unfair to have to cope with this as well as your diagnosis. 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 feel sad and come to terms with it. Talking to someone close to you is usually helpful, although you might not be able to do this for a while.

You might want to talk to someone other than your partner or family members. You might find 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.

Last reviewed: 
13 Jul 2018
  • Cancer and fertility preservation: international recommendations from an expert meeting
    M Lambertini and others
    BMC Med, 2016. Volume 14, Issue 1

  • Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up 
    FA Peccatori and others
    Annals of Oncology, 2013. Volume 24, Issue 6, Pages 160-170

  • Fertility Preservation for Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update
    AW Loren and others
    Journal of Clinical Oncology, 2013. Volume 31, Issue 19, Pages 2500-2510

  • Fertility problems: assessment and Treatment
    National Institute for Health and Care Excellence, February 2013

  • Menopause: diagnosis and management
    National Institute for Health and Care Excellence, 2013

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact patientinformation@cancer.org.uk with details of the particular risk or cause you are interested in.

Information and help