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Life After Cancer: Changes in a Woman’s Fertility 

Cancer can affect a woman’s ability to get pregnant (fertility). A woman is thought to be infertile if she can't get pregnant or carry a pregnancy after a year of unprotected sex. 

This can happen if:

  • You have early menopause

  • Your eggs are damaged or destroyed

  • Your eggs can't become mature and leave the ovaries

  • An egg can’t reach the uterus

  • An egg can’t be fertilized

  • A fertilized egg can’t attach to the uterus

  • A fertilized egg can’t grow in the uterus 

Healthcare providers are still learning how cancer care affects a woman's fertility. Fertility problems depend on:

  • The types of treatment you had

  • The type of cancer and where it was in your body

  • The kinds of treatment you had

  • How long treatment lasted

  • Your age when you had treatment

  • How long it has been since treatment ended

  • Your overall health  

Before treatment 

Talk with your healthcare team before you start treatment. Your team can tell you about how treatments may change your ability to get or stay pregnant. Ask your team about seeing a fertility specialist before treatment starts.

Talk with your team about your options. You may choose to have eggs or embryos frozen. Or you may choose a type of treatment that may help protect your fertility.  

If you have chemotherapy 

Chemotherapy (chemo) can damage the eggs that are in your ovaries. You are born with all of the eggs you will ever have. Some chemo medicines are more likely to harm a woman’s eggs. The effects may depend on the medicines you get, the dose, and how long you were treated. Talk with your healthcare team about the medicines you took, and the risks of each on fertility. You may need to wait at least 6 months after your last chemo treatment to try for a pregnancy. Eggs maturing in the ovaries can be damaged by chemo medicines. 

If you have targeted or immune (biologic) therapy 

Researchers are still learning how these types of medicines affect a woman’s fertility. They don’t work the same as chemo. Some may cause the ovaries to shut down. Or they may cause other problems. Ask your healthcare team what effects your medicines may have on your fertility. 

If you have radiation therapy

Radiation can cause infertility in different ways, such as: 

  • Radiation to the belly, vagina, or uterus can harm the ovaries. This can destroy eggs in the ovaries. Or it can cause the ovaries to stop working.

  • Radiation to the pituitary gland can effect hormones that result in the ovaries not working.

  • Radiation can also cause scar tissue to form in the uterus. This can stop the uterus from stretching to hold a baby. And this can cause problems in a later pregnancy. It may cause miscarriage or early birth.

Your healthcare team can tell you what effects you may have from your treatment.

If you have surgery

Surgery can change your fertility. For example:

  • Scar tissue may block the fallopian tubes. This can stop an egg from reaching the uterus.

  • If you had your uterus removed, you will not be able to carry a pregnancy.

  • If you had both of your ovaries removed, you will not be able to get pregnant without medical help.

  • If you still have your uterus and have one ovary, you may be able to get pregnant.

Your healthcare team can tell you what to expect.

After treatment 

After treatment, your healthcare team can help you manage the effects to your fertility. If you plan to get pregnant after your treatment is done, talk with your team first. Ask how long you should wait after treatment. Some kinds of treatment can harm the eggs that are maturing in the ovaries. This can raise the risk for birth defects. You may need to wait 6 months or more. Your team can give you information to help you make decisions. They can help you find a specialist. And they will let you know when it’s OK to start trying for a pregnancy. They may also be able to help you find adoption or surrogate resources. 

Ask your healthcare team:

  • How does my type of treatment affect fertility in women?

  • Am I healthy enough for pregnancy?

  • Can I use my egg or do I need a donor egg?

  • Am I healthy enough for fertility treatment?

  • When can I start trying to get pregnant?

  • Do I need to see a fertility specialist? Can you refer me to one? 

Seeing a fertility specialist 

After treatment, it may take a while for your menstrual periods to start again. But getting your period may not mean that your fertility is okay. You may want to work with a fertility specialist. He or she can:  

  • Do tests to check your fertility hormone levels

  • See how many eggs are in your ovaries

  • Look for other signs that you can have a baby

  • Help you use eggs or embryos frozen before cancer treatment

  • Help you use eggs or embryos from a donor

The specialist will help you understand your options and what may work best for you.

Working with a fertility specialist may not be covered by health insurance. It's important to know this. Fertility treatments can cost thousands of dollars. In many cases, more than 1 treatment is needed. Talk with the fertility specialist and your health insurer to find out what your own costs will be. 

Getting support 

Fertility changes can be very stressful and upsetting. You and your partner may want to talk with a counselor. Ask your healthcare team for a referral to counseling. They can also help you find a nearby support group or other resources.

Online Medical Reviewer: Lu Cunningham
Online Medical Reviewer: Richard LoCicero MD
Date Last Reviewed: 2/1/2019
© 2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.