Fertility Concerns After Childhood Cancer for Girls and Women
This article has information for any person who had childhood cancer and was born with a uterus, ovaries, fallopian tubes, or vagina.
Fertility (or the ability to have children) after cancer therapy is a very complex topic. It can be hard to tell if and how treatment will affect your fertility. It might depend on:
- The doses and types of medications you had.
- If you had radiation or surgery on your reproductive organs.
- Your age at the time of treatment.
What therapies cause the most risk?
Some treatments are probably more likely to impact your fertility, like:
- Certain anti-cancer medications:
- Alkylating agents: Cytoxan, busulfan, melphalan, BCNU.
- Procarbazine.
- Bevacizumab.
- Cisplatin.
- Some FOLFOX regimens.
- Total body irradiation.
- Bone marrow transplant.
- Radiation to the pelvis or brain. Learn more about the risks related to radiation.
We do not know if newer cancer treatments like targeted and immunotherapies will impact fertility.
How can I learn about my fertility?
It is hard to know if you will be fertile after treatment. You could go into menopause before your peers. There is no way of knowing when this might happen. This is something to think about if you want to have children one day.
It can be helpful for a survivor who wants to become pregnant to see a fertility specialist (often called oncofertility specialist) who works with cancer survivors. Testing can be done to check your fertility, by looking at certain hormone levels and a follicle count (a measure of your egg supply).
Learn more about fertility preservation here.
Should I see a high-risk doctor for my pregnancy?
Women/girls who had cancer treatment may be at higher risk for issues during pregnancy. You may want to see an obstetrician with experience in high-risk pregnancy. This is important if you had radiation to the abdomen or pelvis area, had surgery involving female reproductive organs, or if you had chemotherapy that can cause heart damage.
Preventing Unplanned Pregnancy
Not having a period does not mean you can’t get pregnant. Use effective birth control during and after treatment even if you think you cannot get pregnant.
Resources for More Information
LiveSTRONG Fertility
Provides education and information to cancer patients on fertility risks and referrals to access fertility preservation discounts.
https://www.livestrong.org/what-we-do/program/fertility
Reprotech
Offers support for embryo, semen, oocyte, and ovarian tissue freezing and storage, and fertility preservation information.
The Oncofertility Consortium
Provides a telephone support hotline, education, and clinic/center search options for people with cancer coping with infertility or potential loss of fertility due to cancer treatments.
Resolve
Website of the National Infertility Association. Provides education, advocacy, and information about fertility preservation as well as a database of support groups. Includes information about insurance coverage.