Radiation therapy (also called radiotherapy) uses a controlled dose of radiation to kill cancer cells or damage them so they cannot grow, multiply or spread. It can be delivered from outside the body (external beam radiation therapy) using a machine called a linear accelerator, or inside the body (usually brachytherapy).
The risk of infertility will vary depending on the area treated, the dose of radiation and how many treatments you have.
Radiation to the pelvic area and reproductive organs
Radiation therapy to the pelvic area or any of the reproductive organs commonly causes permanent infertility. It may be used for cancer of the bladder, bowel, cervix, ovary, prostate, rectum, anus, uterus, vagina or vulva.
Your treatment team may try to preserve your fertility by shielding your organs using a screen during radiation treatment, but sometimes this is not possible.
| Radiation therapy to the ovaries | This can stop the ovaries producing hormones and eggs permanently. If you need radiation therapy near the ovaries, one or both may be surgically moved higher in the abdomen and out of the field of radiation. This is called ovarian transposition (oophoropexy). |
| Radiation therapy to the cervix or uterus | This can stop the ovaries producing hormones, and cause permanent menopause. Radiation therapy can also permanently damage the uterus, which means you cannot carry a baby. |
| Radiation therapy to the testicles | This can lower the number of sperm and affect the sperm’s ability to work normally. |
| Radiation therapy to the prostate | This may cause erectile dysfunction, which means not being able to get and keep an erection firm enough for penetrative sex. |
| Radiation therapy to the brain | This may damage the pituitary gland, which releases hormones that control reproduction. It tells the ovaries to release an egg each month and the testicles to make sperm. |
| Radiation therapy to the whole body | This is known as total body irradiation (TBI), and may be given before a stem or bone marrow cell transplant to treat blood cancers. Complications such as miscarriage, premature birth and low birth weight are more common with pregnancies after TBI. |
If you have both chemotherapy and radiation therapy (chemoradiation) to treat cancer, the risk of permanent infertility is higher.
→ READ MORE: The impact of surgery on fertility
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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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