This section covers some common questions men and women ask about fertility and cancer.
How does cancer affect fertility?
Cancer and its treatment may cause fertility problems. This will depend on the type of cancer and treatment you have. Infertility can range from difficulty having a child to the inability to have a child. Infertility after treatment may be temporary, lasting months to years, or permanent.
Some cancer treatments may damage the ovaries and decrease the number of available eggs. Hormone production between the brain and the ovaries may also be affected. Surgery, radiation therapy and chemotherapy to treat cancer may damage reproductive organs. For further details, see Women's fertility and cancer treatments.
Some cancer treatments may affect sperm quantity (low numbers of sperm are made), quality (the sperm that are made do not work properly) or motility (the sperm move poorly). Sometimes the testicles also become damaged or other reproductive organs are removed during surgery. For further details, see Men's fertility and cancer treatments.
"Advances in medical technology helped treat my cancer, then gave my wife and me the chance to become parents." - Craig
How does age affect fertility after cancer?
Age is one of the most important factors that influences the impact of cancer treatment on fertility.
Women's age and fertility
Women are born with all the eggs they will have in their lifetime, but as women age, the number of eggs reduces. Fertility starts to decline after 30 and the decline speeds up after 35. It then becomes harder to conceive and the risk of genetic abnormality in the baby increases.
The impact of cancer treatments can vary with age. Before puberty, the ovaries are more protected from chemotherapy or radiation therapy, although the effect of these treatments on fertility can range from mild to severe, depending on the drugs used and the dose. High doses may sometimes cause enough damage to the ovaries that both the onset of puberty and future fertility are affected. After puberty, the ovaries are more sensitive to the effects of both chemotherapy and radiation therapy, and the risks increase as women get older. Even if reproductive function returns after treatment, women may experience early menopause.
Men's age and fertility
The quality and quantity of men's sperm decreases with age. This means it will take longer for their partner to get pregnant. Before and after puberty, chemotherapy and radiation therapy may affect sperm production and may cause infertility. The effect of radiation will depend on where the radiation is given and dose.
Should I have a child after I've had cancer?
This is a very personal decision. A cancer diagnosis may affect the way you think and feel about having a child. If you have a partner, you may want to discuss your family plans together. Fertility clinics often have counsellors who can talk through the pros and cons of your situation. See Useful websites.
"I was given a good prognosis, but we're still nervous about what happens if it comes back and we leave a child without a parent. That's my biggest concern." - Liam
How long should I wait to conceive after treatment?
This depends on many factors, including the type of cancer and
type of treatment. Some specialists advise waiting two years after treatment ends. This may be to allow your body to recover, and to ensure you remain in good health during this time. It's best to discuss the timing with your doctor.
For some fertility treatments, you will need to take extra hormones or stimulate your hormones. Discuss the potential risks of particular fertility treatments with your cancer or fertility specialist. Taking hormone receptor blockers during egg collection will help reduce the risks.
Will having children cause the cancer to come back?
Research shows that pregnancy does not increase the chances of cancer coming back (recurring). However, studies have mainly focused on women with breast cancer. Research is continuing, so it's best to discuss this issue with your specialist.
To find out more about pregnancy and cancer, see information for women, and for men.
Studies to date also suggest that survival rates for people who have children after cancer treatment are no different from people who don't have children after treatment.
If I've had cancer, will my children get cancer?
Studies show that if one or both parents have a history of cancer, their child is at no greater risk of getting cancer than anyone else. However, a small percentage of certain cancers (up to 5%) are due to an inherited faulty gene from either the mother or father. This is known as familial cancer. The faulty gene increases the risk of cancer, but even then it does not mean that a child will inherit the gene and develop cancer. For more information, see If cancer genes are present.
A genetic counsellor is the most qualified person to give you up-to-date information about the genetic risks of cancers for family members.
"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 starting 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 uncommon - it is estimated that one in every 1000 pregnant women is diagnosed with cancer.
It may still be possible to have cancer treatment during pregnancy. It's best to discuss the potential risks and benefits with your oncologist before treatment begins. In some cases, 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 the early weeks of pregnancy decide to terminate the pregnancy so they can start treatment immediately, while others who are diagnosed later in the pregnancy choose to deliver before the due date.
You will be advised not to breastfeed during chemotherapy as drugs can be passed to the baby through the breastmilk. It may not be possible to breastfeed during other treatments. For support, call the Australian Breastfeeding Association on 1800 686 268.
Expert content reviewers:
Dr Yasmin Jayasinghe, Paediatric Gynaecologist, Royal Children's Hospital Melbourne, Co-chair Fertility Preservation Taskforce, Melbourne, and Senior Lecturer, Department of Obstetrics and Gynaecology, University of Melbourne, VIC; Dr Peter Downie, Head, Paediatric Haematology-Oncology and Director, Children's Cancer Centre, Monash Children's Hospital, and Director, Victorian Paediatric Integrated Cancer Service, VIC; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland; Aaron Lewis, Consumer; Pampa Ray, Consumer; Dr Sally Reid, Gynaecologist, Fertility SA and Advanced Gynaecological Surgery Centre, Visiting Consultant, Women's and Children's Hospital, and Clinical Senior Lecturer, School of Paediatrics and Reproductive Health, The University of Adelaide, SA; A/Prof Kate Stern, Head, Fertility Preservation Service, The Royal Women's Hospital and Melbourne IVF and Head, Endocrine/Metabolic Clinic, Royal Women's Hospital, and Co-chair, AYA cancer fertility preservation guidance working group, VIC.