Find answers to common questions about cancer and fertility. Discover how cancer treatment may affect the ability to conceive.
Infertility is defined as a condition where a person or couple is unable to conceive.
This may result from female or male factors, or a combination of both, or the reasons may be unknown.
- For females under 35, the term usually refers to trying unsuccessfully to conceive for 12 months.
- If a female is 35 or older, the term is used after 6 months of trying.
Cancer and its treatment may affect your fertility, depending on the type of cancer and treatment you have.
Chemotherapy and radiation therapy can damage reproductive organs involved in creating or carrying an unborn baby, such as the ovaries, uterus or testicles. Sometimes these organs are damaged or removed during surgery, which can harm or destroy eggs or sperm, or make it difficult to carry a pregnancy to term.
Fertility problems after treatment may only last months to years or they may be permanent.
Learn more about treatment side effects and fertility.
Call Cancer Council 13 11 20 for free booklets and information about different cancer types and their treatments or download them from our Resource hub.
Age is one of the most important factors in how cancer treatment affects fertility.
Female age and fertility
| Natural decline in female fertility | Females are born with all the eggs they will have in their lifetime. From the age of 30, fertility starts to decline and this decline speeds up after 35. It then becomes harder to conceive and the risk of chromosomal conditions (e.g. Down syndrome) increases.
From your early 40s, although you may still have regular periods, it is usually difficult to conceive a child because of lower egg quality. After menopause, it won’t be possible to conceive a child naturally. |
| Cancer treatment and age-related effects on fertility | How cancer treatments affect fertility will vary. Before and after puberty, the effect of chemotherapy and radiation therapy on fertility depends on the drugs used or the dose. |
| Before puberty | Before puberty, high doses of drugs or radiation to the pelvis may cause enough damage to the ovaries that both puberty and future fertility are affected. |
| After puberty | After puberty, treatment to the ovaries can cause periods to stop permanently. Even if periods return after treatment, some women may experience medically induced menopause. |
Male age and fertility
The quality and quantity of sperm decreases with age. This means it may take longer for an older man’s female partner to get pregnant.
Before and after puberty, chemotherapy and radiation therapy may affect sperm production and may cause infertility. The impact of radiation will depend on the dose and what organs are affected by the radiation.
This describes the procedures that can help preserve your fertility, for example, freezing eggs, embryos or sperm, or using injections that cause a temporary state of menopause to preserve your ovaries.
Other procedures include freezing ovarian or testicular tissue.
If a cancer treatment may affect your fertility, fertility preservation procedures are usually done before treatment begins.
Your fertility may also be protected during treatment – for example, with ovarian transposition or radiation shielding.
Timing of pregnancy and when to use contraception is an important discussion to have with your cancer specialist. Some cancer specialists advise waiting between 6 months and 2 years after treatment ends. This may be to allow your sperm or eggs to recover, and to ensure you remain in good health.
If you have a hormone-sensitive cancer and are taking anti-oestrogen drugs, you will need to wait for 9 months after you finish taking these drugs before getting pregnant.
Research shows that for most types of cancers, pregnancy does not increase the chances of cancer coming back. Research is continuing, so discuss this issue with your specialist.
Studies to date suggest that survival rates for people who have children after cancer are no different from people who don’t have children after treatment.
This is a very personal decision. Many people who have had cancer do go on to have children. Others decide not to have children. Having cancer may change the way you feel about having a child. Having a family is very important to many cancer survivors and with advice from specialists, this can be safe and successful.
If you have a partner, discuss your family plans with each other and with your treatment team. Worrying about cancer coming back may make it hard for you to make plans, including having a child. Fertility clinics often have counsellors who can talk through your situation. Ask to be referred to a counsellor who has experience in both cancer and fertility.
Studies show that if one or both parents have a history of cancer, their child has the same risk of getting cancer as anyone else. About 5% of some cancers are caused by an inherited gene fault from either parent. This is known as familial cancer.
If you inherit a gene fault from either of your parents, this will increase the risk of you developing cancer. You may also pass on this gene fault to your children.
If your diagnosis is linked to an inherited gene fault, you may consider having preimplantation genetic testing (PGT) as part of in-vitro fertilisation (IVF). This involves testing embryos for genetic conditions. Only unaffected embryos are implanted into the uterus. This reduces the chance of the gene being passed on to the child.
A fertility clinic can provide more information.
Being diagnosed with cancer during pregnancy is uncommon – it is estimated that 1 in every 1000 pregnant females are diagnosed with cancer. Call Cancer Council 13 11 20 for more information about pregnancy and cancer.
Treatment during pregnancy – This may be possible, but you need to discuss the potential risks and benefits to you and the baby with your oncologist before treatment begins. In some cases, treatment can be delayed until after the baby’s birth. For some cancers, chemotherapy may be safely used after the first trimester (12 weeks), usually with a break of a few weeks before the birth.
Termination – Some people diagnosed with cancer in the early
weeks of pregnancy decide to terminate the pregnancy so they can
start treatment immediately.
Change in birth plan – If you are diagnosed later in the pregnancy, you may be able to have the baby before the due date.
Breastfeeding – You will be advised not to breastfeed while having
chemotherapy, targeted therapy, or immunotherapy as drugs can
be passed to the baby through the breastmilk. If you are having
radiation therapy, talk with your doctor about whether it is safe to
continue breastfeeding during treatment.
My oncologist wanted to start treatment as soon as possible, so my obstetrician and oncologist decided on a day to deliver my son. He was delivered safely at 32 weeks.
Lily
Why fertility matters
Fertility is an important part of health for everyone. But your doctor may not discuss whether you want children in the future if they make assumptions based on your age, sexual orientation, gender, or whether you have children or not, or if they are focused on starting treatment immediately. If fertility matters to you, let your health professional know before treatment begins.
Talking to your cancer specialist
Ask your cancer specialist about the chances of your treatment causing fertility problems and what you can do now if you want to have a child later (e.g. freezing eggs, or ovarian, sperm or testicular tissue).
Planning treatment to protect fertility
Ask to be referred to a fertility clinic or oncofertility specialist, or if it is possible to plan treatment in ways that protect or limit damage to reproductive organs to reduce the chances of infertility after treatment.
Booking a fertility appointment
Tell the fertility clinic or oncofertility specialist that you are having treatment for cancer so that they can arrange an appointment for you as soon as possible. Your cancer care team may also be able to help you get an appointment quickly.
What can the fertility clinic help with?
The fertility clinic can give you information about:
- how your age and cancer treatment might affect fertility
- the options available to you
- how likely it is that each option will lead to pregnancy
- costs of the different options
- using donor eggs or sperm in the future
- any counselling you might need.
Including your partner or a support person
If you have a partner, try to attend appointments together and include them in the decision-making process. You may also wish to bring a family member or friend for support.
Fertility preservation can be expensive, and this may influence your decision-making. The cost of fertility treatment varies – you may be able to have treatment at a fertility unit in a public hospital or a private clinic.
Ask your fertility specialist for a written estimate of their fees and any Medicare rebates. Ask your private health fund (if you belong to one) what costs they will cover and what you’ll have to pay.
Types of costs to expect
Depending on the treatment you have, costs may include:
- fertility specialist appointments – ask if they offer a discount for people diagnosed with cancer
- medicines and blood tests
- fees for procedures (e.g. the different steps in the IVF cycle for egg or sperm collection, preimplantation genetic testing, and implantation of embryos after treatment)
- day surgery, operating theatre and anaesthetist fees
- egg, sperm and embryo storage (cryopreservation) – ask your clinic about up-front payments, instalment payments and ongoing fees.
If you need in-vitro fertilisation (IVF) to have a baby in the future (e.g. by using your frozen sperm, eggs or embryos), private fertility clinics will usually charge their standard fees.
Learn more about cancer care and your rights and cancer and your finances.
Medicare will cover the cost to see a specialist only if you have a referral. The referral should list both you and your partner so you can claim the maximum benefit.
→ READ MORE: Which health professional will you see?
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Dr Sally Reid, Gynaecologist and Fertility Specialist, Obstetrics and Gynaecology (Adelaide) and Royal Adelaide Hospital, SA; Dr Sarah Ellis, Clinical Psychologist and Postdoctoral Research Fellow, Kids Cancer Centre, Sydney Children’s Hospital and UNSW, NSW; John Booth, Consumer; Hope Finlen, Haematology Nurse Consultant, Gold Coast University Hospital, QLD; Dr Michelle Harrison, Medical Oncologist – Gynaecological cancers, Chris O’Brien Lifehouse, NSW; Melissa Jones, Nurse Consultant, Youth Cancer Service SA/NT, Royal Adelaide Hospital, SA; Dr Violet Kieu, Clinical Director, Melbourne IVF and Fertility Specialist, The Royal Women’s Hospital, VIC; Prof Declan Murphy, Consultant Urologist, Director – Genitourinary Oncology, Peter MacCallum Cancer Centre and The University of Melbourne, VIC; Stephen Page, Family and Fertility Lawyer, and Legal Practice Director, Page Provan, QLD; Ann Retzlaff, 13 11 20 Consultant, Cancer Council WA; A/Prof Kate Stern AO, Fertility specialist, Gynaecologist and Reproductive Endocrinologist, Royal Women’s Hospital and Melbourne IVF, VIC; Georgia Webster, Consumer.
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