How Cancer Treatments Impact Fertility

Cancer treatments such as chemotherapy, radiation, or surgery, can affect the reproductive system for men and women. Longer treatment duration and higher doses of radiation or chemotherapy increase the risk of adverse effects on fertility.

Before undergoing cancer treatment, men and women can preserve their reproductive potential with fertility preservation treatments such as egg, sperm, embryo, and ovarian and testicular tissue freezing.

Cancer and Male Fertility

Cancer treatments and their effects on male fertility include:

Chemotherapy: destroys rapidly dividing cells in the body. This targets cancer cells but can destroy healthy ones as well. Some chemotherapy agents are more harmful than others; age, type of chemotherapy, and drug dosage can influence the fertility risk.
Radiation: destroys rapidly dividing cells in and around a target area. Radiation directed at or near the testicles can genetically damage sperm and cause infertility. Radiation to the hormone-producing areas of the brain or the pituitary gland may also cause infertility by disrupting normal hormone production. However, radiation to other areas of the body do not typically affect fertility.
Bone Marrow/Stem Cell Transplants: involves high doses of chemotherapy and sometimes full body radiation to destroy a patient’s bone marrow and/or stem cells prior to replacing with new cells. The combination of treatments and their intensity put the patient at high risk of infertility.
Targeted Medication: targets certain cancer proteins or other cancer characteristics. While the protein-targeting medications may affect fertility, other medications appear to have little to no effect on male fertility.
Surgery: removes cancer-ridden parts of the body. Infertility can result when parts of the reproductive system – such one or both testicles – are removed.

Cancer and Female Fertility

Cancer treatments and their effects on female fertility include:

Chemotherapy: destroys rapidly dividing cells in the body. This targets cancer cells but can destroy healthy ones as well, which can damage or destroy eggs. Some chemotherapy agents are more harmful than others; age, the type of chemotherapy, and the drug dosage can influence the fertility risk.
Radiation: destroys rapidly dividing cells in and around a target area. This can damage the reproductive system when directed at or near the pelvic area. Radiation to the hormone-producing areas of the brain or the pituitary gland may also cause infertility by disrupting normal hormone production. The target area of the radiation and dose impacts the risk level.
Bone Marrow/Stem Cell Transplants: involves high doses of chemotherapy and sometimes full body radiation to destroy a patient’s bone marrow and/or stem cells prior to replacing with new cells. The combination of treatments and their intensity put the patient at high risk of infertility by damaging the ovaries and uterus, which may prevent future chances of carrying a pregnancy.
Targeted Medication: targets certain cancer proteins or other cancer characteristics. Medications that target other cancer characteristics appear to have no effect on female fertility but can impact pregnancy.
Surgery: removes reproductive systems if they are found to contain gynecologic cancers, such as ovarian, uterine, or cervical cancer. Removing the ovaries, uterus, cervix or other reproductive organs can cause infertility and eliminate chances of carrying a pregnancy.