Life After Cancer: Changes in a Woman’s Fertility
Cancer can affect a woman’s ability to
get pregnant (fertility). A woman is considered infertile if she can't get pregnant or
carry a pregnancy after a year of unprotected sex.
This can happen if:
You have early menopause
Your eggs are damaged or
Your eggs can't become mature
and leave the ovaries
An egg can’t reach the
An egg can’t be fertilized
A fertilized egg can’t attach to the uterus
A fertilized egg can’t grow in
Doctors are still learning how cancer
treatments affect a woman's fertility. Fertility problems depend on:
The types of treatment you had
The type of cancer and where it
was in your body
The kinds of treatment you
How long treatment lasted
Your age when you had
How long it has been since
Your overall health
Talk with your healthcare team
before you start treatment. Your team can tell you about how treatments may change your
ability to get or stay pregnant. Ask your team about seeing a fertility specialist
before treatment starts.
Talk with your team about your
options. You may choose to have eggs or embryos frozen. Or you may choose a type of
treatment that may help protect your fertility.
If you have chemotherapy
Chemotherapy (chemo) can damage the
eggs that are in your ovaries. You are born with all of the eggs you will ever have.
Some chemo medicines are more likely to harm a woman’s eggs. The effects may depend on
the medicines you get, the dose, and how long you were treated. Talk with your
healthcare team about the medicines you took, and the risks of each on fertility. You
may need to wait at least 6 months after your last chemo treatment to try for a
pregnancy. Eggs maturing in the ovaries can be damaged by chemo medicines.
If you have targeted or immune (biologic)
Researchers are still learning how these types of medicines affect a woman’s fertility. They don’t work the same as chemo. Some may cause the ovaries to shut down or other problems. Ask your healthcare team what effects your medicines may have on your fertility.
If you have radiation therapy
Radiation can cause infertility in different ways. For example:
Radiation to the belly (abdomen), vagina, or uterus can damage
the ovaries. This can destroy eggs in the ovaries. Or it can cause the ovaries to
Radiation to the pituitary gland can effect hormones that result
in the ovaries not working.
Radiation can also cause scar tissue to form in the uterus. This
can stop the uterus from stretching to hold a baby. And this can cause problems in a
later pregnancy. It may cause miscarriage or preterm birth.
Your healthcare team can tell you what effects you may have from your
If you have surgery
Surgery can change your fertility. For example:
Scar tissue may block the fallopian tubes. This can prevent an
egg from reaching the uterus.
If you had your uterus removed, you will not be able to carry a
If you had both of your ovaries removed, you will not be able to
get pregnant without medical help.
If you still have your uterus and have one ovary, you may be
able to get pregnant.
Your healthcare team can tell you what to expect.
After treatment, your healthcare
team can help you manage the effects to your fertility. If you plan to get pregnant
after your treatment is done, talk with your team first. Ask how long you should wait
after treatment. Some kinds of treatment can damage the eggs that are maturing in the
ovaries. This can raise the risk for birth defects. You may need to wait 6 months or
more. Your team can give you information to help you make decisions. They can help you
find a specialist. And they will let you know when it’s OK to start trying for a
pregnancy. They may also be able to help you find adoption or surrogate resources.
Ask your healthcare team:
How does my type of treatment
affect fertility in women?
Am I healthy enough for
Can I use my egg or do I need a donor egg?
Am I healthy enough for
When can I start trying to
Do I need to see a fertility
specialist? Can you refer me to one?
Seeing a fertility specialist
After treatment, it may take a
while for your menstrual periods to start again. But getting your period may not mean
that your fertility is okay. You may want to work with a fertility doctor. He or she
Do tests to check your fertility hormone levels
See how many eggs are in your ovaries
Look for other signs that you can have a baby
Help you use eggs or embryos frozen before cancer treatment
Help you use eggs or embryos from a donor
The doctor will help you understand your options and what may work
best for you.
Working with a fertility specialist
may not be covered by health insurance. It's important to know this. Fertility
treatments can cost thousands of dollars. In many cases, more than 1 treatment is
needed. Talk with the fertility specialist and your health insurer to find out what your
own costs will be.
Fertility changes can be very
stressful and upsetting. You and your partner may want to talk with a counselor. Ask
your healthcare team for a referral to counseling. They can also help you find a nearby
support group or other resources.