Late Effects Assessment Programme: Female fertility

Late Effects Assessment Programme: Female fertility

You will want to know if your cancer and cancer treatment will affect your fertility. Some do and some don't. Talk to your healthcare team.

Key points to remember

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 nornal pregnancy and not need any special care

Will I be infertile from the cancer or treatment I had?

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 (more difficulty conceiving) due to reduced stores of eggs. Certain treatments may also cause early menopause.

Which treatments can result in infertility or reduced fertility?

Chemotherapy

Chemotherapy with certain drugs - specifically alkylating agents. The most common alkylating agents used in treating childhood cancer are Cyclophosphamide, Melphalan, Busulfan, CCNU, and BCNU, Thiotepa and Procarbazine. The greatest risk is from high total doses of these drugs and/or radiation to the brain, pelvis or lower spine.

The most commonly used alkylating agents for childhood cancers are: Cyclophosphamide, Melphalan, Busulfan, CCNU, BCNU, Thiotepa, Procarbazine - the greatest risk is from high total doses of these drugs and/or radiation to the brain, pelvis or lower spine.

Radiation

Radiation to the abdomen, pelvis, lower spine and total body irradiation (TBI).

Surgery

Surgery to the ovaries or uterus.

Radiation

Radiation or surgery to the brain.

How do I know if this is a problem for me?

These are important issues for young people. If you have been through puberty, and are having regular periods, the chances are that you are not totally infertile. You can have blood tests at this time to check if you are producing enough hormones.

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

There are specialised tests to assess fertility. These include ultrasound of the ovaries or blood tests that can assess the number of eggs you have.

What options are there if my fertility has been affected?

There are a number of options available to help you achieve a pregnancy.

There are a number of options available to help you achieve a pregnancy. If necessary, your healthcare team can make a referral to a specialist fertility clinic - they can check your fertility more fully and you can discuss treatments and available options.

Remember that 1 in 10 couples are infertile in the general population.

Currently, no test is 100 percent accurate for females

If the type of treatment you had is very likely to have affected your fertility, you will get more specific information when you go to clinic.

What about my sex life?

Fertility and sexual function are different. Even if you are told you are infertile you can still have a normal sex life.

Remember to use contraceptives. Don't assume you'll be infertile from your treatment. And, protect yourself from STDs.

Should I use contraceptives?

Yes! Do not assume that because you have had some of these treatments you will be infertile. It is important that you take precautions until you are ready to have a family. It is also important to protect yourself from sexually transmitted diseases.

If I become pregnant, 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 lead maternity carer know you have had cancer and what treatment you had.

Make sure your midwife LMC (lead maternity carer) refers you to your local secondary maternity service for a consultation early in your pregnancy. Specialised obstetric oversight is free at your local secondary maternity service.  If you are already under the care of an obstetrician LMC this will not be necessary

Give your maternity carer a copy of your treatment summary or 'health passport' at your first appointment.

What if I 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.

What if I had a type of chemotherapy called anthracyclines?

You may need to take special care if you had a type of chemotherapy called anthracyclines. These include Doxorubicin, Daunorubicin, Epirubicin, Idarubicin and Mitozanthrone. See the pages 'Your heart' and 'Pregnancy and heart health'.

Will my baby have cancer?

Some young cancer survivors worry that the treatment they had may affect their baby. There is no evidence of increased health problems or abnormalities in children of people who have had treatment for cancer. Except for some rare inherited cancers, there is also no evidence that children of cancer survivors have an increased risk of developing cancer compared to other people.

You can discuss all these issues at your clinic

You can discuss any of these issues in more detail when you go to clinic. The risk of any problems with fertility is different for everyone.

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 February 2013.
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