How cancer treatments affect fertility

Cancer treatments have the potential to affect fertility. It's important to understand how and why this happens before you begin your treatment.

Infertility after cancer treatments may arise because:

• the ovaries are not able to produce mature eggs (ovarian failure), this can be temporary or permanent
• the ovaries are damaged by the chemotherapy or radiotherapy, causing loss of some of the eggs (oocytes)
• hormonal signalling between the brain and the ovaries has been disrupted
• there is damage to the uterus or fallopian tubes from surgery or radiotherapy.

Each treatment has its particular risks to your future fertility.

Surgery

If there is surgery to the abdomen or the pelvis, there may be associated damage with scarring to the uterus, ovaries or more commonly the fallopian tubes. This may cause difficulty with the sperm and egg meeting prior to fertilisation. Occasionally, it is necessary to remove the ovaries and/or the uterus and fallopian tubes which can make you infertile.

Chemotherapy

Chemotherapy acts on rapidly dividing cancer cells to destroy them. Some chemotherapy drugs can damage the eggs and follicles in your ovaries, which can cause temporary or permanent damage.

The effect on fertility will depend on the following:

• your age (as women get older the ovaries are more vulnerable to the effects of the drugs)
• types of drugs used
• dose of drugs
• length of time drugs are used.

Radiotherapy

Radiotherapy acts on rapidly dividing cells in a particular area of the body.

Radiation can also act on healthy cells. When radiotherapy is directed to the pelvis it may damage the ovaries and the uterus.

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