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Female fertility and cancer treatments This leaflet provides information about the effects of cancer treatment on female fertility. It will explain what infertility is and what options are available to you if your cancer treatment makes you infertile. Contact telephone numbers and details of how to obtain further information are provided at the end of the leaflet. What is infertility? Infertility is the inability to become pregnant naturally. Cancer treatment and fertility Surgery, radiotherapy, chemotherapy and hormonal therapy are the four main treatments for cancer. Each of these treatments can affect a woman’s fertility. Surgery Some operations will permanently stop you being able to have a child. For example if you have your womb removed (hysterectomy); if you have both of your ovaries removed (a bilateral oophorectomy); and some types of surgery to your cervix or vagina. Radiotherapy Radiotherapy to your ovaries or pelvis can cause infertility. This will be permanent. The risk of infertility depends on the dose of radiotherapy you receive and your age when you have your treatment. 1 Women who have total body irradiation (TBI) will normally be permanently infertile afterwards. Radioactive iodine is very unlikely to affect fertility. Chemotherapy Chemotherapy can cause infertility. This may be temporary or permanent. This will depend on: The chemotherapy drug used – some drugs are more likely to affect your fertility, and combinations of drugs are more likely to affect your fertility than single drugs The dose of the drug used – higher doses are more likely to affect fertility Your age – younger women are more likely to retain normal fertility Your general health Hormonal therapy Some hormonal therapies affect fertility. This is usually temporary whilst you receive treatment. However, for some women hormonal therapies cause an early menopause. This is when your ovaries stop producing eggs, your periods stop, and hormonal changes can cause hot flushes and vaginal dryness. When will my risk of infertility be discussed with me? Your doctor will discuss your risk of infertility with you before you start treatment. If you have a partner, they may wish to join you for this discussion so that you are both aware of all the facts and can talk about your feelings and options. 2 Can infertility be prevented? Research into preserving fertility is being developed. It is still experimental and many people feel that more research needs to be carried out to establish their effectiveness. Your doctor will discuss this further if you would like more information. What options are available to me if I may become permanently infertile? If your infertility is likely to be permanent your doctor will explain what options may be available before you start your treatment. It is important to realise that any procedures will delay the start of your treatment. They may also have a low success rate. What options may I have after my cancer treatment has made me infertile? Your doctor will discuss what options are available to you. This could include a referral to the Cardiff Assisted Reproduction Unit (CARU) at the University Hospital of Wales. A consultation will include discussing what treatments may be suitable for you. You may need to pay privately for this as it may not be funded by the NHS. Should I use contraception during my treatment? There is sometimes uncertainty about whether infertility will occur so it is important that you use contraception during your treatment and for 6-12 months after. This is because chemotherapy and radiotherapy could damage the unborn baby. 3 Contact telephone numbers We understand that the issues raised in this leaflet are complicated. If you would like to discuss anything further or would like more information please contact your doctor or one of the phone numbers below. Information and Support Radiographers 029 2061 5888 ext 6428 Macmillan www.macmillan.org.uk 0808 808 0000 The Daisy Network www.daisynetwork.org.uk Premature menopause support group 0845 122 8616 Cardiff Assisted Reproduction Unit www.caru.co.uk 029 2074 3047 Human Fertilisation and Embryology Authority (HFEA) www.hfea.gov.uk This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated annually. Reviewed June 2010 4