Women, fertility and cancer

If you’re a woman about to start cancer treatment, you may have concerns about how any treatment might affect your fertility, both now and in the future.

The information on this page will help you to find out more about women, fertility and cancer, including ways of preserving fertility.

Fertility in women explained

Put simply, fertility for a woman means being able to get pregnant and have a baby.

It's a process which can only happen naturally when a woman releases an egg (ovum), and it is fertilised by male sperm.  Women are generally fertile once their periods start, and fertility lessens gradually as they get older. 

Women become naturally infertile, once they have been through the menopause - the time in a woman’s life when periods permanently stop.

This complex process can be hampered by many factors.  Fertility needs reproductive organs, and a finely tuned hormone production system.  When cancer and treatments are added, it can have a temporary or permanent effect on fertility.

Cancer and women’s fertility

There are a range of cancer treatments which can affect a woman’s fertility.  Your specialist doctors and healthcare team should explore how you feel about fertility issues before you start treatment.  This is so that measures can be taken to preserve your fertility where possible. 

Don’t hesitate to let your team know if you might be planning another child after your treatment finishes. Sometimes, assumptions may be made that if you already have a child, fertility may not be a high priority. However, for you, it may be an important consideration.

Preserving your fertility

There are several ways to help preserve fertility in women.  It may be by freezing eggs or embryos. To preserve eggs the specialists give medications which stimulate your ovaries. This produces more eggs which can then be collected and frozen. 

Alternatively, eggs can be fertilised using sperm. Any eggs which produce embryos can then be frozen. The NHS will store eggs and embryos for ten years. If being stored longer this may need to be paid for.  

Newer techniques, involving freezing sections of the ovary, are possible, but not readily available everywhere yet.  Your specialist doctors will check if these procedures are possible, in individual cases. Fertility using these methods is a way of helping to have a baby after cancer, but are not always successful.

If having radiotherapy treatment, it is sometimes possible to temporarily move the ovaries out of the treatment area. The procedure is called an ovarian transposition, and is carried out laparoscopically (through keyhole incisions in your lower abdomen). Your specialist can determine if this is possible for you.

Cancer treatments may only stop periods temporarily.  However, fertility may not return for some women, particularly if nearing menopause. 

It is advisable to take contraceptive precautions whilst on treatment as cancer treatments can affect growing embryos, and during early pregnancy.  Your doctor will be able to tell you which contraceptive method is most suitable for you alongside your treatment.

Treatments which may affect fertility 

There are a number of cancer treatments which can affect a woman’s fertility:

• Surgery - you may need surgery which affects your fertility. This could include operations involving the pelvis or reproductive system (womb, cervix, vagina, fallopian tubes or ovaries).  Specialist doctors will try to preserve fertility wherever possible.
• Chemotherapy - many chemotherapy treatments can affect fertility.  The return of fertility can depend on how old you are, the type of chemotherapy you have, and the dose strength.  Contraception is advisable during your chemotherapy treatment, even if your periods have temporarily stopped.
• Radiotherapy - pelvic radiotherapy can affect your fertility, as it may impact on your womb, fallopian tubes or ovaries.  Permanent infertility risk increases as you get older, and the dosage of radiotherapy you have. Radiotherapy can also be used to treat areas in the brain, which may impact on the pituitary gland, affecting hormone production and fertility.
• Targeted/immuno/biological therapies - these treatments are relatively new, so there isn’t a great deal of information on how they affect fertility.  Some targeted therapies, however, have been found to cause fertility issues. Your specialists will explain which therapy drugs may be used, and how they impact on fertility.
• Bone marrow and stem cell transplants - these treatments usually stop any release of further eggs for fertilisation.  It’s therefore important to discuss fertility before starting this form of treatment.
• Hormone therapies - drugs such as Tamoxifen and Zoladex, for example, can affect fertility. They may be used to treat breast cancer and other hormone dependant cancers.  Any fertility issues this may cause is usually temporary.

Fertility after cancer treatment 

After cancer treatment, you may start thinking about having a family. It can take time to reach this decision.  You’ve been through a great deal, and it takes a while for the mind and body to recover. You may be concerned about what happens if your cancer comes back. 

Your specialist may recommend waiting a period of time before trying to get pregnant, so your body is fully recovered. You may need additional help and support to get pregnant after cancer. You can ask your specialist to refer you to a fertility clinic.

Some people find having sex difficult after having cancer treatment - either for physical reasons like pain and tiredness or for emotional reasons.  You can find out more in our section on sex, intimacy and cancer.

You may be concerned that your cancer has a genetic cause, and this can sometimes be a consideration before getting pregnant after cancer.  Talk through your worries with your specialist team. They can refer you for genetic counselling if your risk factors are higher than normal.  Read more in our section on cancer in families.

Sometimes, women decide that having their own biological child becomes less of an issue, after having cancer.  Some people opt to try for adoption, or having a child by surrogacy (another woman bearing a child for them).  

If having a child doesn’t happen, it's natural to feel sadness, grief and loss. These feelings can take time to come to terms with, and be difficult, after all that you’ve been through.  There are organisations which can help address these natural feelings, for example: Fertility Network UK

You can also ask for counselling, which helps resolve and address the range of emotions you’re experiencing.

Cancer, children’s fertility and cancer

Some cancer treatments can cause infertility in children and teenagers, as a late effect. It is something your child’s consultant should discuss with you and your child (if they are at age to understand). 

There are a number of preserving fertility measures that can be taken. It is a specialised area, and individual procedures are changing as new ways of preserving fertility are found. You can find out more in the links at the bottom of the page, or checking with your child’s specialist team.

How Maggie’s can help

Fertility concerns are understandable, particularly if you've recently had a cancer diagnosis, or about to start treatment. You may need clarity on some of the options discussed, or simply need to offload the immense feelings you’re experiencing. You and your partner may find your relationship is being affected by all the stresses cancer brings. 

Maggie’s can provide support and information - as well as ways to relieve stress, and strategies to cope.  You can attend as a couple, or as individuals.  Ask about Maggie’s ‘managing relationships’ workshops. 

You can spend time talking with others, or in a ‘one to one’ with one of our cancer support specialists. 

Drop into your local Maggie’s centre to find out more.  You can also look through our online links and blogs to access more information.

Last review: Feb 2022 | Next review: Feb 2023