“Fertility” describes the ability to conceive a biological child. Human reproduction requires three elements: mature sperm, mature eggs and a person with a uterus to carry the pregnancy and give birth. Some cancers and some cancer treatments affect fertility.
When first diagnosed with a blood cancer, your primary concern may be your upcoming treatment and long-term survival. You may not be thinking about whether you can or want to have children in the future. However, information about the potential effects of your treatment can help you take steps to leave your options for family building open after cancer treatment.
Addressing fertility and sexual health is an essential part of cancer treatment and follow-up care. It is important to talk with members of your healthcare team before treatment begins about the potential effects of your treatment.
Not all cancer treatments affect fertility. Your risk depends on several factors, including
- Your age at the time of diagnosis and treatment
- The type and dosage of chemotherapy drug(s) you receive
- Alkylating agents, for example cyclophosphamide, ifosfamide and procarbazine, along with the drug cisplatin, have the most significant effect on fertility. Other drugs are generally less toxic to sperm-forming cells and eggs, but can also cause infertility, especially when used as part of a combination of therapies.
- The location and dosage of radiation
- Exposure to the testes may destroy cells that form sperm.
- Exposure to the ovaries may destroy eggs.
- Exposure to the pituitary gland in the brain or thyroid at the base of the neck may cause changes in secretion of hormones that regulate puberty and fertility.
- Exposure to the uterus (womb) may cause damage making it difficult to carrry a pregnancy safely.
- The duration of treatment
- Whether you received a blood or marrow stem cell transplantation, which is associated with a high risk of infertility
- The type of cancer
- Certain cancers cause a decrease in the number of sperm. For example, patients with Hodgkin lymphoma may have a low sperm count at the time of diagnosis due to the effect of the cancer itself.
- Download or order The Leukemia & Lymphoma Society’s free fact sheet, Fertility Facts.