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. The Late Effects Assessment Programme (LEAP) can help.

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

Not all cancers and cancer treatments can affect your fertility, 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 in conceiving) due to reduced stores of eggs. Certain treatments may also cause early menopause.

Infertility or reduced fertility may result from:

  • certain types of chemotherapy drugs, specifically alkylating agents. 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 if combined with radiation to the brain, pelvis or lower spine
  • radiation to the abdomen, pelvis, lower spine and total body irradiation (TBI)
  • surgery to the ovaries or uterus
  • 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. Blood tests can be done 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 that can be used to assess fertility including ultrasound of the ovaries or blood tests that can assess the number of eggs you have. There are a number of options available to assist in achieving a pregnancy: if necessary a referral can be made to a specialist fertility clinic where your fertility can be checked more fully, and treatments and options that are available can be discussed.

Currently, no test is 100 percent accurate for females

If the type of treatment you had means you are at a high risk of your fertility being affected, you will be given more specific information when you come 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.

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?

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 where specialised obstetric oversight is free.  If you are already under the care of an obstetrician LMC this will not be necessary

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

One in 10 couples is infertile in the general population.

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 a cancer compared to other people.

These issues can be discussed in more detail when you come to clinic as the risk of any problems with fertility is different for everyone.

Where can I get more information?

The following are good websites to checkout:

Center for Young Women's Health: www.youngwomenshealth.org

Fertility Hope: www.fertilehope.org

Fertility Associates: www.fertilityassociates.co.nz

Fertility in Females brochureAll the information in the Childhood cancer section of this website has 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 National Child Cancer Network Clinical Leader.

This page last reviewed 26 February 2013.
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