Talking about fertility

Sunday 1 May, 2016

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Your doctor should discuss any risk to your fertility before you start cancer treatment.

If you are concerned about your fertility, you may need to raise the topic with your treatment team – see below for some suggestions on how to start this conversation.

Some people feel too overwhelmed with the amount of cancer information they are given to bring up fertility concerns. You may prefer to wait and see if the topic is raised at a consultation. However, even if you aren’t sure what you want, it’s important that your doctor knows fertility is a priority for you. This gives your specialists the opportunity to work towards keeping your fertility options open for the future.

Ways to raise the topic of fertility

You have the right to bring up fertility issues with your health professionals at any time. Here are some suggestions:

  • Before we start treatment, I want to talk about my fertility options with a specialist. Who would you recommend?
  • How will this treatment affect my chances of having a child in the future?
  • Will any of these chemotherapy drugs reduce my fertility?
  • Should I think about storing sperm/eggs/embryos before treatment starts?

Seeing a fertility specialist

Fertility specialists are doctors who have experience managing fertility issues. Those who have completed additional training are sometimes called reproductive endocrinologists. You may also see a fertility counsellor or a genetic counsellor.

When making an appointment, let the clinic or specialist know that you are having treatment for cancer so that they give you an appointment as soon as possible. During the appointment, the specialist will talk through what you want and the options available to you. Your treating cancer doctor will give input, and together you can decide what works with your cancer treatment plan.

If you have a partner, try to attend appointments together and include them in the decision-making process. Alternatively, you may wish to bring a family member or friend for support.

Some people find the process of talking to a fertility specialist stressful. You may want to plan some questions in advance and take notes of what is discussed so you can review them later. The information about dealing with emotional issues and the impact on your relationships may also be helpful.

"The first time I met my surgeon she said, ‘You should go and see a fertility specialist.’ It all happened very quickly. The only way to describe the process is that it was overwhelming. However, it’s better not to delay it." – Mackenzie
Feeling respected

Anyone diagnosed with cancer should be able to have a direct and honest conversation with their doctor about fertility and be able to explore their options, regardless of sexual preference or age. You don’t need to have a partner to have these types of discussions.

It is important that you (and your partner, if you have one) feel respected and included in all discussions with health professionals. Building an open and trusting relationship with your treatment team will enable you to ask questions and seek support.

Not feeling ready

A cancer diagnosis may mean you need to make decisions about your fertility before you’ve given much thought to whether you want to have a child in the future. This may make you feel stressed and overwhelmed, particularly when you have just been diagnosed with cancer.

Even if you think, ‘But I don’t want kids anyway’ or ‘My family is complete’, try to give yourself as many choices as possible because you might change your mind later. The section about informed decision-making may be helpful.

Your fertility specialist or counsellor will probably encourage you to consider as many fertility options as possible.

Reviewed by: Prof Roger Hart, Medical Director of Fertility Specialists of Western Australia and Professor of Reproductive Medicine, School of Women’s and Infant Health, University of Western Australia, WA; Dr Antoinette Anazodo, Paediatric and Adolescent Oncologist, Sydney Children’s and Prince of Wales Hospitals, Director of the Sydney Youth Cancer Service, NSW; Brenda Kirkwood, 13 11 20 Consultant, Cancer Council Queensland, QLD; Dr Michael McEvoy, Director of Clinical Services, Flinders Fertility, SA; Eden Robertson, Research Officer, Behavioural Sciences Unit, Sydney Children’s Hospital, NSW; Kayla Schmidt, Consumer; A/Prof Kate Stern, Head of Fertility Preservation Service, The Royal Women’s Hospital and Melbourne IVF, Head Endocrine and Metabolic Service, Royal Women’s Hospital and Clinical Director, Melbourne IVF, VIC; and Prof Jane Ussher, Centre for Health Research, Western Sydney University, NSW. 

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