If you are of childbearing age, it’s likely you had a conversation with your oncologist prior to starting cancer treatment regarding your future ability to have children. The two of you may have also talked about ways to preserve your fertility, such as collecting and storing healthy eggs or semen before beginning cancer treatment for use after treatment.

Now that your cancer treatment has ended, you might feel ready to start or grow your family. But as excited as you are, you might also feel nervous about the unknowns. Here are answers to some of the most common questions cancer survivors have as they consider expanding their families. Keep in mind that fertility often depends on the type of cancer you had as well as the type of treatment you received. Therefore, the most accurate answers will come from your cancer care team as they will better understand your current situation.

Common Survivor Concerns About Post-Cancer Fertility

After cancer treatment, will I be able to conceive a child?  

The answer to this question varies based on a few different factors including the type of cancer you had, the treatments you received, and how your body responded. 

Women

• Chemotherapy -  Certain types of chemotherapy can cause egg damage and infertility.  View the list on the American Cancer Society website. 

Various chemotherapy drugs can also weaken the heart, which could result in a dangerous pregnancy or early menopause (the absence of menstrual period which causes permanent infertility.) 

• Radiation therapy - Both internal (brachytherapy) and external radiation given to organs such as the abdomen, pelvis, lower spine, ovaries, uterus, pituitary gland, can reduce a woman’s ability to become pregnant after treatment. 
• Surgery - Surgical removal of all or part of the uterus, cervix, one or both ovaries, or pelvic lymph nodes can hinder a woman’s ability to become pregnant or carry a pregnancy to term. 

Men

• Reduced sperm count is a potential side effect of radiation therapy or chemotherapy. In some cases, sperm production returns to normal over time (usually 10 to 24 months after treatment). In other cases, reduced sperm count can be permanent.  
• Surgical removal of organs such as the bladder, prostate, one or both testicles, or pelvic lymph nodes may cause infertility in men.

How long should I wait after cancer treatment before trying to get pregnant?

There is no definite rule about how long to wait if your oncologist feels as though you are ready. With that said, there are times when waiting will be recommended. For example, doctors often advise men to wait 2 to 5 years after cancer treatment before trying to conceive a child naturally since cancer treatment can damage the DNA of sperm. Many survivors express concern about their cancer treatments increasing the risk of conceiving a child with birth defects. However, studies have found no increase in the rates of birth defects in children conceived by a parent who has undergone cancer treatment. 

For women, most oncologists recommend waiting at least 6 months from the date of their final chemotherapy to try and get pregnant. This is because this is about how long it takes for eggs damaged during cancer treatment to leave the body. In some cases, though, oncologists recommend waiting up to 5 years after finishing cancer treatment to conceive a child depending on whether there are other hormone therapies or other treatments required after chemotherapy and radiation therapy is complete.

Is there a possibility of passing cancer along to a new baby?

At this time, there is no evidence that conceiving a child after cancer treatment increases the cancer risk for that child. However, some cancers are hereditary. Depending on the type of cancer you had, there may be an increased risk that your child will develop that cancer during their lifetime. This does not guarantee that your baby would develop cancer, it simply means his or her risk may be higher than that of the general public. Cancers known to be passed down through generations include breast, ovarian, colorectal, and prostate cancers. If you were diagnosed with one of these cancers, you may want to talk to your oncologist about genetic counseling and genetic testing.

Regardless of Your Post-Cancer Fertility, You Can Still Become a Parent

If cancer treatment left you infertile and you did not take steps or know you could have taken steps to preserve your fertility before treatment (such as freezing your eggs or sperm) there are still several ways to become a parent. Thanks to donor eggs, donor sperm, surrogates who will carry your fertilized embryo to term, adoption, etc., you can still have the family you’ve dreamed of, even if your journey to parenthood is different than the journey you had envisioned.