Female Fertility After Childhood Cancer

Key points about female fertility after childhood cancer

• not all cancers and cancer treatments cause infertility
• some do, so it is important to understand your individual risks
• the risk of any problems with fertility is different for everyone
• most women who have had cancer will have a normal pregnancy and not need any special care

Will I be infertile from either my cancer or my treatment?

Not all cancers and cancer treatments cause infertility but some do so it is important to understand your individual risks. You may not be able to become pregnant and have a child. Or, you may have reduced fertility due to reduced stores of eggs. Certain treatments may also cause you to stop having periods at a younger age.

Why can infertility happen for females after childhood cancer?

Chemotherapy

If you've had chemotherapy with certain drugs, your healthcare team will talk to you about your individual risk of infertility. The most common chemotherapy treatments to cause infertility are Ifosphamide, Cyclophosphamide, Procarbazine, Melphalan, Thiotepa, CCNU, and BCNU. Your level of risk depends on how much you've had.

Radiation

Your fertility may be affected if you have had total body irradiation (TBI) or radiation to your:

• abdomen
• pelvis
• lower spine
• brain (affects your hormones)

Surgery

Surgery to your female reproductive organs can affect your fertility.

Changes to your hormones

This can happen after radiation or surgery to the brain.

How do I know if infertility is a problem for me after childhood cancer?

There are a number of options available to help you get pregnant if your fertility is affected.

If you are having regular periods, this is a good sign. You can have blood tests to check that you are producing enough hormones.

There are other tests to check your fertility. These include an ultrasound of your ovaries (where your eggs are stored) or blood tests that can check the number of eggs you have. Currently, no test is 100% accurate for females.

Some young females may not go into puberty and will need to take hormone-replacement medicine.

Your healthcare team can talk with you about these issues in more detail.

Check out an introduction to long-term follow-up in childhood cancer

What are my options if my fertility has been affected after childhood cancer?

There are a number of options available to help you get pregnant. Your healthcare team can get you an appointment with a fertility clinic to talk about these in more detail.

Should I use contraception after childhood cancer?

Make sure to use condoms - protect you and others from STDs. And, don't assume you will be infertile from your treatment!

Yes, it's important to use contraception! Don't think that just because you've had some of these treatments, you will be infertile. It's also important to use condoms to protect yourself from sexually transmitted diseases.

If I become pregnant after childhood cancer, do I need to do anything different?

Most women who have had cancer will have a normal pregnancy and not need any special care.

If you become pregnant, it is important to let your family doctor and midwife know you have had cancer and what treatment you had. You may need more specialist care during your pregnancy.

If you've had radiation or major abdominal surgery, you may be at risk of premature labour. Or, you may need a caesarian section to deliver your baby.

You may need to take special care if you had a type of chemotherapy medicine called anthracyclines. 

For more information, see the pages:

• Your heart after childhood cancer
• Pregnancy and heart health after childhood cancer

Make sure your healthcare team have a copy of your treatment summary from the Late Effects Assessments Programme (LEAP).

Will my children get cancer if I've had cancer treatment?

Some young people who have had cancer worry that their treatment may cause health problems in their own tamariki (children). There is no evidence that this is the case. Except for some rare inherited cancers, there is also no evidence that your child will have an increased risk of developing cancer.

What if I have more questions about my fertility after childhood cancer?

You can talk to your healthcare team about any of these issues in more detail.

Read more about long-term follow-up in childhood cancer

Read more about childhood cancer