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Conceiving after cancer

Starting a new family is something that many couples plan for years in advance, but receiving a cancer diagnosis can bring uncertainty and fears about making this goal a reality. Fortunately, the dream of having a child can come true for many who have fought cancer, thanks to new treatment options that protect fertility for both men and women. In addition, there are a variety of assisted reproductive technologies (ART) available for starting a family, keeping that door open to almost everyone.

Can I get pregnant?

Many women wonder if motherhood will be an option after cancer treatment, and women with gynecologic cancers may be especially concerned. Studies show that most radiation and chemotherapy treatments will not have a lasting effect on fertility once treatment is complete. In these cases, the road to conception is the same as it is for a woman who has never faced cancer.

In general, most women are advised to wait a minimum of six months to start trying to conceive after finishing cancer treatment, to allow the body to heal and to improve egg vitality.

Fertility concerns for men

Like women, many men are concerned about fertility after cancer treatment. Prostate cancer is the most common type of cancer found in American men, after skin cancer. The prostate helps produce semen, so questions about future fertility are common.

Treatment for prostate cancer and other types of cancer can have a temporary or permanent effect on a man’s fertility, depending on the type of treatment received. Chemotherapy can reduce sperm production or limit sperm mobility, while radiation to or near the testicles can harm sperm production. Also, radiation to the brain (e.g., pituitary gland) can affect fertility by interfering with normal hormone production, affecting sperm count. After treatment is complete, doctors advise waiting six to 12 months for the sperm to regenerate before trying to conceive.

Fertility-sparing cancer treatment options

There are many treatment approaches that can help minimize or prevent any fertility side effects of cancer treatment. Here are some fertility-sparing treatments that you may want to discuss with your doctor, to discover whether they are options for you.

  • Surgery – New, minimally invasive surgical techniques can preserve fertility, by sparing a reproductive organ. For example, for women with ovarian cancer, a surgeon may be able to remove one ovary, allowing the other to remain intact. For men who choose prostate cancer surgery, which eliminates ejaculation, sperm can be retrieved from the testicles after treatment and cultured with an egg using in vitro fertilization (IVF). 
  • Radiation – For some, radiation therapy offers a better treatment option than surgery, because it allows the reproductive organs to remain in the body. HDR Brachytherapy, which can be used for both prostate and gynecologic cancers, deposits radiation inside a tumor, with less damage to the nearby healthy tissue. Another tool, the Calypso 4D Localization System™, allows doctors to continuously track movement of the prostate in real time and concentrate radiation to the tumor, reducing the chances of urinary and sexual side effects. 
  • Chemoprotective drugs – Chemoprotective drugs can be administered at the same time as chemotherapy to protect healthy cells from chemotherapy drugs, while still targeting the cancer cells. If the reproductive organs are protected from the side effects of chemotherapy treatment, sperm and egg quality can be preserved. 
  • GnRH analog treatment – This experimental option uses long-acting hormones to cause a woman to go into menopause for a short time. The hormones are usually given before cancer treatment to decrease activity in the ovaries, and reduce the number of eggs that are damaged.

If you are concerned about cancer treatments affecting your fertility, perhaps consider freezing eggs, sperm or embryos prior to treatment. Take a look at our “Tips on Starting a Family After Treatment” for more information on assisted reproductive technologies (ART), and other options for becoming a parent after cancer treatment.

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