Female fertility after childhood cancer

Female fertility after childhood cancer

Some cancers and cancer treatments can affect your fertility. Talk to your healthcare team about your individual risk.

Key points to remember about female fertility after childhood cancer

This page is written for young people who have had cancer treatment.

  • not all cancers and cancer treatments cause infertility
  • some do so it is important to understand your individual risks
  • the risk of any problems with fertility is different for everyone
  • most women who have had cancer will have a normal pregnancy and not need any special care

Will I be infertile from either my cancer or my treatment?

Not all cancers and cancer treatments cause infertility but some do so it is important to understand your individual risks. You may not be able to become pregnant and have children. Or, you may have reduced fertility due to reduced stores of eggs. Certain treatments may also cause you to stop having periods at a younger age.

Why can infertility happen for females after childhood cancer?

Chemotherapy

If you've had chemotherapy with certain drugs, your healthcare team will talk to you about your individual risk of infertility. The most common chemotherapy treatments to cause infertility are Ifosphamide, Cyclophosphamide, Procarbazine, Melphalan, Thiotepa, CCNU, and BCNU. Your level of risk depends on how much you've had.

Radiation

If you've had radiation to your abdomen, pelvis, lower spine, brain (affects your hormones) or total body irradiation (TBI), this can affect your fertility.

Surgery

Surgery to your female reproductive organs can affect your fertility.

Changes to your hormones

This can happen after radiation or surgery to the brain.

How do I know if infertility is a problem for me after childhood cancer?

There are a number of options available to help you get pregnant if your fertility is affected.

If you are having regular periods, this is a good sign. You can have blood tests to check that you are producing enough hormones.

There are other tests to check your fertility. These include ultrasound of your ovaries (where your eggs are stored) or blood tests that can check the number of eggs you have. Currently, no test is 100 percent accurate for females.

Some young girls may not go into puberty and will need to take hormone replacement medicine.

Your healthcare team can talk with you about these issues in more detail.

What are my options if my fertility has been affected after childhood cancer?

There are a number of options available to help you get pregnant. Your healthcare team can get you an appointment with a fertility clinic to talk about these in more detail.

Remember to use contraceptives and protect yourself from STDs with condoms. Don't assume you'll be infertile from your treatment!  

Should I use contraception after childhood cancer?

Yes, it's important to use contraception! Don't think that just because you've had some of these treatments you will be infertile. It's also important to use condoms to protect yourself from sexually transmitted diseases.

If I become pregnant after childhood cancer, do I need to do anything different?

Most women who have had cancer will have a normal pregnancy and not need any special care.

If you become pregnant it is important to let your family doctor and midwife know you have had cancer and what treatment you had. You may need more specialist care during your pregnancy.

If you've had radiation or major abdominal surgery, you may be at risk of a premature labour. Or, you may need a caesarian section to deliver your baby.

You may need to take special care if you had a type of chemotherapy called anthracyclines - see the pages 'Your heart after childhood cancer' and 'Pregnancy and heart health after childhood cancer'.

Make sure your healthcare team have a copy of your treatment summary from the Late Effects Assessments Programme (LEAP).

Will my children get cancer if I've had cancer treatment?

Some young people who have had cancer worry that their treatment may cause health problems in their own children. There is no evidence that this is the case. Except for some rare inherited cancers, there is also no evidence that your child will have an increased risk of developing cancer.

What if I have more questions about my fertility after childhood cancer?

You can talk to your healthcare team about any of these issues in more detail.

All the pages in the childhood cancer section of this website have been written by health professionals who work in the field of paediatric oncology. They have been reviewed by the members of the National Child Cancer Network (NZ). Medical information is authorised by the clinical leader of the National Child Cancer Network.

This page last reviewed 26 November 2018.
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