A cancer diagnosis is heartbreaking – and not something anyone prepares for in their lifetime. Cancer and treatments for cancer not only impacts your health but also can affect your future fertility chances. However, in the same way, that cancer treatments are advancing all the time, treatments to help you have a healthy, happy baby after a cancer diagnosis are also improving.
If you have been diagnosed with cancer, your doctor should offer you the chance to discuss your diagnosis and how it impacts your fertility in the long run. However, you may also want to do a little bit of research yourself, to help you take some control of your future. In this blog post, we’ll discuss how both cancer and treatments for cancer can impact fertility – as well as the many treatment options you have to help you have a family in the future.
How cancer can impact fertility
It is a common misconception that all cancer can affect fertility in men and women. If cancer affects the male or female reproductive organs – such as ovarian and testicular cancer – there may well be a connection with fertility issues in the future. Generally speaking, it is the cancer treatments, rather than cancer itself that can affect your fertility.
How cancer treatment can impact fertility
Men
Different types of cancer treatment have different effects on male fertility. Chemotherapy has a known effect on damaging sperm and sperm forming cells known as germ cells. Hormone therapy may also decrease the amount of sperm produced.
Radiation therapy to either the male reproductive organs or near the abdomen may destroy sperm cells. Radiation therapy in general can also affect the brain – more specifically the pituitary gland, which produces testosterone and determines the production of sperm. The different effects cancer treatments have on sperm production and quality can combine to decrease the level of male fertility and make natural conception harder.
Women
Chemotherapy and radiotherapy are key and regularly used cancer treatments. Many studies have shown that chemo and radiotherapy can affect ovaries and stop them from releasing eggs and oestrogen. This condition is called premature ovarian insufficiency. Depending on the lengths and dose of the therapy, sometimes your fertility and periods may return to normal after treatment, but this is not guaranteed and can take a while in some cases. Cancer treatment may also reduce the number of viable eggs in the ovary which makes it harder to conceive.
Fertility preservation
The good news is that before you start cancer treatment, you will be given the option to preserve your fertility. This will often be offered through the NHS, but your cancer team may refer you to a fertility clinic ahead of your treatment.
Egg and sperm preservation is a procedure that involves freezing and storing eggs and sperm for use in the future. This is known as cryopreservation. However, with any procedure, it depends on several factors such as type of cancer, treatment plan and urgency of cancer treatment. For men, sperm preservation is simple as it involves the collection of a sperm sample and can be stored for 10 years or more.
For women, egg collection and storage needs a little more time. Ovarian stimulation is needed for egg collection which can take several weeks. If your cancer treatment plan allows, this can be a possibility, however, sometimes this ovarian stimulation may worsen your cancer. If the cancer is aggressive and needs immediate treatment, unfortunately, it’s often necessary to prioritise your health rather than taking the time to go through the egg freezing process. This was the situation for Parla Co-Founder Rose Acton, who is currently fighting a brain tumour and Lynch Syndrome. You can read more about Rose’s story here. This is an important and difficult conversation to have with your cancer team and fertility specialist before deciding on cryopreservation.
If you are in a couple and know you want to have children together, there may also be an option to freeze embryos with your egg and sperm together. Whilst success rates are fairly similar between frozen eggs and frozen embryos, some believe that frozen embryos actually fare better.
Treatment options to help you have a baby after cancer
When you have finished your cancer treatment and are ready to have a baby, you have a few different options for your next step, including IVF, surrogacy and donor eggs and sperm. It’s also important to remember that there is always a chance you will be able to conceive naturally after cancer treatment. Your medical team will do any necessary tests and advise you of your best option.
IVF
IVF involves multiple steps and is a long procedure, but it is seeing increasing success rates. Usually, IVF starts with removing healthy eggs from a woman’s ovary or collecting a sperm sample. If you have already frozen your eggs or sperm however, you are already one step ahead!
These eggs will be thawed and then fertilised with sperm in a laboratory. For male cancer survivors, the sperm will be thawed and combined with their partner’s or donor egg. After successful fertilisation, the embryo is then returned to the uterus to let it develop and mature. Most of the time, it is recommended for only one fertilised egg (embryo) to be put back into the womb, but occasionally on doctor’s advice, two embryos might be used. It is advised to wait around 2 weeks before taking a pregnancy test to see if the procedure has worked.
Donor Sperm/Eggs
Though this is an entirely different form of assisted fertility, it technically falls under IVF. If you and your partner don’t have viable eggs or sperm left after cancer and treatment, you may be able to receive them from a donor to help you conceive. These eggs or sperm are usually brought in to the IVF process.
It’s fairly simple to connect with sperm donors at sperm banks around the UK, however, finding an egg donor has proven to be more tricky. There are companies and fertility clinics in the UK that offer services to help couples find egg donors. If you are using a fertility clinic, they will be able to provide you with more information. All couples using egg or sperm donors have to undergo mandatory counselling usually provided by the fertility clinic. This might be something to discuss with your cancer team too.
Surrogacy
Sometimes couples might need to turn to a surrogate to help them conceive a child. If cancer and treatment involved the removal of the woman’s uterus, this prevents the female partner from carrying a child. A surrogate is a woman who would carry and deliver the baby for you. However, they would not be the parent of the baby. When using a surrogate, you can use your own eggs and sperm or donor eggs and sperms with the surrogate. However, there are some laws in the UK regarding surrogacy. It is important to read and familiarise yourself with them before embarking on this journey. We’ve shared some information about surrogacy in our LGTBQ fertility blog post here.
Navigating a fertility journey can sometimes be hard – but combined with a cancer diagnosis it can feel even more challenging. We hope this blog has given you some guidance and comfort. If you are looking for more support you can Join Parla to access our expert-led community.
