Key questions

Sunday 1 June, 2014

Download PDF Order FREE booklet

This page covers some common questions men and women ask about fertility and cancer. Some of your responses to these questions will depend on your personal views and preferences.

You should seek independent legal advice for complex fertility questions. For example:

  • If my partner dies after we’ve stored embryos, would they have been willing for me to use the embryos?
  • What are the rules and ethical considerations about donating unused embryos?
  • If I use a surrogate, what are the issues I need to consider?
  • If my child is conceived using donor tissue, what are their rights at age 18?

Should I have a child after I’ve had cancer?

The way you think and feel about having a child will probably be affected by the diagnosis. Some people are reluctant to start a family because they worry about dying or doubt their ability to physically and emotionally raise a child. Others do have a child after cancer.

There is no simple answer to this personal question. You should seek advice from a fertility specialist or counsellor, who can talk through the pros and cons of your situation. If you have a partner, you may want to discuss your family plans together. This question list may help you to consider this.

When should I discuss fertility or see a specialist?

It’s best to talk about your fertility options before cancer treatment begins. Your oncologist will be able to refer you to a fertility specialist and may help you get an appointment before you start treatment.

If you don’t have the opportunity to see a fertility specialist before treatment, ask your GP or oncologist for a referral to discuss your future options. 

For some suggestions about how to raise the topic of fertility, see talking about fertility.

What is my risk of infertility?

The American organisation Livestrong provides reproductive information for people affected by cancer, including an infertility risk calculator. Men or women select their cancer type or treatment and the calculator predicts how their fertility could be affected.

It’s important to remember that this calculator is a general guide only. You should discuss your individual risk with a local fertility specialist who can give you personalised advice and support. 

How does age affect fertility after cancer?

Cancer treatment plays a large role in determining your fertility, but your age also affects it.

Women

Age is considered the greatest indicator of future pregnancies for women. Regardless of cancer, the older you are, the harder it becomes to fall pregnant.

The younger you are at the time of cancer treatment, the less likely you are to become infertile. Generally, it’s expected that a woman who is treated with chemotherapy before the age of 30 is more likely to get pregnant after treatment has finished.

However, you may be at risk of premature ovarian failure and/or early menopause.

Men

Fertility levels naturally decline between the ages of 40–50. Cancer treatment can cause infertility in men of all ages, as well as boys who have not reached puberty at the time of their treatment. 

Does having periods mean a woman is fertile?

Women’s periods (menstruation) may stop or become irregular as a result of some cancer treatments. If periods stop permanently (menopause), this causes infertility. 

A woman sometimes regains her periods after finishing treatment, but this may or may not indicate she is fertile.

Doctors don’t always know how each person’s body will react to their particular treatment. Some women return to a normal reproductive state within a couple of months of finishing treatment, but some don’t. 

If I’m fertile after treatment, should I use frozen tissue?

In general, it’s considered better to conceive naturally using fresh eggs or sperm you are producing. If you stored sperm, eggs or embryos before treatment, talk to your fertility specialist about your options, including if you would like to use them and how long you would like to keep them. 

How long can reproductive tissue be frozen?

Sperm, eggs and embryos can be stored for many years, even decades. There have been some cases where healthy children have been successfully produced from sperm that was frozen for 30 years. 

"Advances in medical technology helped treat my cancer, then gave my wife and I the chance to become parents. I’m amazed at what was possible." – Craig

Do fertility treatments cause cancer?

There are no direct links between fertility treatments and cancer. However, some fertility treatments require you to take additional hormones or stimulate your hormones, and it’s still unknown how safe this is for people with hormone-sensitive cancer. Talk to your cancer or fertility specialist about the risks associated with fertility treatment.

Will having children cause cancer recurrence?

Research shows that pregnancy does not increase the chances of cancer recurrence. However, studies have mainly focused on women with breast cancer. Further studies are being done, so it’s best to discuss this issue with your specialist. See more information about pregnancy and cancer below. Studies to date also suggest that survival rates for people who have children after cancer treatment are as good as for those who don’t have children after treatment.

Some people wonder how long they should wait to conceive after cancer treatment. This depends on many factors, including the type of cancer, so discuss the timing with your doctor. Some specialists advise waiting two years after a cancer diagnosis. This may be to allow your body to recover, or to see if you have cancer recurrence during this time. 

Are children of cancer survivors likely to have health problems?

Research to date suggests that children born to cancer survivors (after treatment has ended) are no more likely to have birth defects than the general population.

Studies show that if one or two parents have a history of cancer, their child is at no greater risk of getting cancer than anyone else. The exception is if cancer runs in the family through a faulty gene. For more information, see when cancer genes are present.

However, some fertility techniques may be associated with a slightly higher risk of birth defects that aren’t linked to cancer. One example is intracytoplasmic sperm injection. Your fertility specialist or genetic counsellor is the most qualified person to give you up-to-date information about the risks of particular treatments. 

If I didn’t preserve my fertility treatment, do I still have options?

Yes, however your fertility options will depend on your sex, cancer type, treatment type, age and how much time has passed since treatment ended.

A general overview of fertility options can be found in the women’s options after cancer treatment and men’s options after cancer treatment sections. 

"My oncologist wanted to start treatment as soon as possible, so it was a case of my obstetrician and oncologist deciding on a day to deliver my son, then start my cancer treatment. He was delivered safely at 32 weeks." – Lily

What if I was already pregnant at diagnosis?

Being diagnosed with cancer during pregnancy is rare – about one in 1000 women are affected.

It may still be possible to have cancer treatment during pregnancy. The potential risks and benefits need to be discussed before treatment begins. Sometimes treatment can be delayed until after the birth. If necessary, chemotherapy can be safely used after the first trimester (12+ weeks).

Some women diagnosed with cancer in early stages of pregnancy decide to terminate it so they can immediately start chemotherapy. For women wishing to breastfeed, learning that this is not possible during chemotherapy may be distressing.

What are my options if I don’t want to use fertility treatments?

Giving birth or getting your female partner pregnant aren’t the only ways to become a parent – see other paths to parenthood. Alternatively, some people decide not to have children. 


Reviewed by: Prof Martha Hickey, Head of Obstetrics and Gynaecology, University of Melbourne, VIC; Franca Agresta, Clinical Research Manager, Melbourne IVF, VIC; Alyssa White, National Publications Project Manager, Cancer Council NSW; and Georgia Mills, Cancer Survivor.

Updated: 01 Jun, 2014