Key Points for This Section
Radiation therapy and chemotherapy may cause infertility (being unable to have children). This may be temporary or permanent. The risk of infertility as a side effect of cancer treatment depends on the following:
- Age at time of treatment.
- Type and dose of radiation therapy and/or chemotherapy.
- Where in the body the radiation is given.
- Whether you had one type of therapy or more than one.
- How long ago you had treatment.
Ask your doctor if your cancer or its treatment may cause infertility or sexual side effects. Your doctor can tell you what changes may happen. A child may be too young to understand issues about infertility or sexuality. Parents can decide what they want their child to know about these issues.
Talk to your doctor before treatment if you are concerned about the effects of cancer treatment on your ability to have children. Your doctor can recommend a counselor or fertility specialist who can tell you your options and help you and your partner make a decision. Options may include freezing sperm, eggs, or ovarian tissue before cancer treatment.
The following chemotherapy agents have been shown to affect fertility:
Fertility is likely to get better the longer you have been off chemotherapy. If you are taking chemotherapy, your age is an important factor. In women older than 40 years, adjuvant hormone therapy increases the risk that chemotherapy will cause infertility.
A man's age and the amount of radiation given directly to the testicles affects his risk of infertility. Lower doses of radiation and using lead shields to protect the testicles can help men keep their fertility. Sperm counts usually take 10 to 24 months to return to the level they were before radiation therapy. Usually, the higher the radiation dose, the longer it takes to recover. If the body is not making hormones normally, hormone therapy may help restore fertility. Radiation given to boys who have not reached puberty can cause problems with fertility.
Radiation therapy to the ovaries may cause infertility in women of any age. High doses of radiation in women younger than 26 years may cause early menopause. Lower doses of radiation can cause infertility in women older than 40 years. Regaining fertility is more likely if radiation to the ovaries is given before puberty. Doctors are sometimes able to protect the ovaries during radiation therapy.