Frequently Asked Questions About Fertility and Cancer

Should I have children after I’ve had cancer?

After a cancer diagnosis, many people wonder if they should even think about having children. They may question whether a genetic factor might have caused them to get cancer and if they might pass this cancer gene to their children. But only about 5% to 10% of cancers have a strong link to a gene that is passed on from parent to child. (See Do children of cancer survivors have higher risks of getting cancer? )

Survivors also may worry that treatment with chemo or radiation could cause birth defects or other health problems for future children. Studies have found that babies conceived after cancer treatment don’t have birth defects or health problems any more often than babies whose parent didn’t have cancer. But problems are more likely if a baby is conceived during or too soon after cancer treatment, so it’s important to know how long to wait before trying to have a baby.

It helps to get as much information as you can before you make a decision that will affect the rest of your life as much as this one will. You might want to discuss these concerns with a genetic counselor, geneticist, reproductive specialist, and/or a mental health professional.

Depression, anxiety, and stress may affect your ability to think as clearly as you would like about your reproductive choices. Talk about these issues and concerns with the people whose opinions you value and trust – your spouse or partner, health care team, family, close friends, clergy, etc. There are support groups as well as health professionals who deal with fertility issues for people with cancer. Ask your doctor to refer you to one of these specialists.

Is pregnancy safe after cancer?

Despite concerns that pregnancy could cause cancer to return, studies to date have not shown this to be true for any type of cancer. Breast cancer is the type most people worry about because of the hormone changes that happen during pregnancy. So far, studies suggest that survival rates in women who become pregnant after breast cancer are as good as in women who do not. But this issue is still being studied. Every cancer is different, so it’s not possible to say for sure that it’s safe for all cancer survivors to become pregnant.

You also need to know that pregnancy could be a problem if cancer treatment has damaged your heart, lungs, or other organs. When organs are damaged, the added physical stress of a pregnancy can lead to serious health problems for the mother and the growing fetus.

Radiation that reaches the uterus, especially if it was done when the woman was a child, can limit the ability of the uterus to stretch as the fetus grows. This creates an increased risk of a premature or low birth-weight baby, or even having a miscarriage.

If you are thinking about getting pregnant after cancer, it’s a good idea to first see a specialist in high-risk obstetrics to find out if you have any health risks because of your cancer treatment. Your cancer doctor can also talk with you about how your health, your cancer and cancer treatment, and your risk of cancer coming back might affect pregnancy and parenthood.

If I didn’t act to preserve my fertility before cancer treatment, is it too late or do I still have options?

The answer to this question depends on your type of cancer and treatment. This is something you need to discuss with your oncologist. You may need to see a fertility specialist.

After cancer, how will I know if I need to see a fertility specialist?

It’s best to discuss fertility with your oncologist first, because everyone’s cancer diagnosis and treatment is different. But if you’ve had trouble conceiving for 6 months, despite having sex at the right times of the month, you might have a fertility problem and should consider seeing a specialist.

Do fertility drugs cause cancer?

A few early studies suggested a link between some fertility drugs and cancer, but recent studies suggest there’s no direct link between the use of fertility drugs and breast, uterine, ovarian, or any hormone-related cancer. If you are getting any of the drugs that stimulate eggs, talk with your doctor or nurse about their short- and long-term risks and side effects.

Are the rates of birth defects higher in children born to cancer survivors who have had treatments like chemo and/or radiation therapy than in the general public?

So far studies suggest that children born to cancer survivors are only very slightly more at risk than others in the general public to have birth defects. In a very large study in Sweden and Denmark, over a period of 20 years, over 96% of children born after a father's cancer treatment were healthy. There was a very small increase in risk of a major birth defect (about 1% if a child was conceived within two years of the father’s treatment). 

After cancer treatment, how long should I wait to conceive?

There is no set time. It’s very important to discuss this with your doctor to find out what’s best for you. One study found a slightly higher rate of birth defects in children conceived within 6 to 24 months after a man’s cancer treatment.

How long can embryos, eggs, sperm and tissues be frozen?

Indefinitely. Samples have been stored for decades without damage. Most of the risk occurs in the freezing and thawing processes, so once they are frozen they can be stored for many years.

What role does age play in fertility for men after cancer?

In general, a man’s fertility will begin to decline between ages 40 and 50. But cancer treatment can affect fertility in men of all ages, including boys who have not yet reached puberty.

Chemo may be more damaging to sperm production in men who are over 40.

What role does age play in fertility for women after cancer?

For women, getting older is a factor in fertility whether you have cancer or not. The older you are, the harder it is to get pregnant. Many do not realize that fertility declines rapidly after age 35, even in healthy women. Cancer treatments that cause premature menopause affect a woman’s fertility.

Research suggests that the younger a woman is when she gets damaging cancer treatments, the less likely it is that she will become infertile. This may be because a younger woman has more eggs in reserve, so more eggs are likely to remain alive after treatment.

Do children of cancer survivors have higher risks of getting cancer?

Research shows that no unusual cancer risk has been identified in the offspring of cancer survivors. The exception to this is in families who have true genetic cancer syndromes. If there’s a lot of cancer in your family, you might want to check with a genetic counselor to see if any of your potential children would have a higher than usual chance of having cancer.

If it looks like I am fertile after treatment, should I use the sperm I froze before treatment?

Make this decision with the help of a fertility specialist. Most fertility specialists recommend that cancer survivors who recover fertility should try to conceive naturally with the sperm they are producing, but more research is needed in this area.

If it looks like I am fertile after treatment, should I use the embryos or eggs I froze before treatment?

Make this decision with the help of a fertility specialist or a reproductive endocrinologist. Most fertility specialists would recommend that cancer survivors who recover fertility should try to conceive naturally. There’s no proof of an increased risk of birth defects in children born after cancer treatment. If you have trouble getting pregnant naturally, however, your frozen eggs or embryos are a great backup.

Do cancer survivors have trouble adopting because of their medical history?

One study did show a bias of adoption agencies against allowing adoptions by cancer survivors. Most adoption agencies say they do not rule out cancer survivors as parents. But they often require medical exams and a letter from an oncologist saying that the cancer survivor has a good prognosis (outlook for survival).

Some agencies may require a cancer survivor be cancer-free for 5 years before applying for adoption. In recent years, all but a few countries have stopped allowing cancer survivors to adopt internationally.

Some discrimination clearly does occur both in domestic and international adoption. Yet, most cancer survivors who want to adopt can do so. You may be able to find an agency that has experience working with cancer survivors.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: June 8, 2015 Last Revised: June 8, 2015

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