Fertility is the ability to have a biological child. To be infertile means that you are unable to conceive or father a child.
Your ability to have a biological child is known as your fertility. If you are infertile, it means your body is not able to conceive, or father, a child.
Cancer and cancer treatments can have an effect on fertility. Fertility effects that come from cancer therapy may be temporary or permanent. Some cancers occur in parts of the body that can cause permanent damage to fertility.
There may not be any effect on your fertility at the time of your cancer treatment, but cancer therapy could cause your fertility to decline at a younger age than it would have.
Not all cancers and cancer treatments will affect fertility but some can, so it is important to understand your individual risks. Your cancer team will be able to advise if your cancer or cancer therapy may pose a risk to your fertility.
Considering fertility when making treatment decisions
Dealing with a cancer diagnosis can be overwhelming and considering fertility risks can seem like a low priority while coping with a life-threatening illness. We recommend that you ask your surgeon, oncologist or nurse about whether there is a possibility your fertility could be at risk from your planned cancer therapy. They can help you assess the risk or refer you to someone who can guide you. They should inform you of possible options for fertility preservation or refer you some one else who can. Ask about fertility as early in your cancer journey as you can as this can mean you have more options for protecting or preserving your fertility.
For young people, making decisions about fertility preservation can be particularly stressful as having a family may not have been something they had begun considering before their cancer diagnosis. Whānau support can be useful in decision making, and you can ask your treatment team for a referral to a support service such as a counsellor to help cope with the difficult emotions arising from fertility discussions.
For parents of younger children with cancer, if you have concerns about how your treatment decisions may affect your child's future fertility you can discuss these with your child’s oncologist. There are currently options available for some young children whose cancer therapy poses a significant risk to their future fertility.
There are several types of fertility preservation options available in New Zealand. Some are funded (according to set eligibility criteria) but for some, fertility preservation may not be funded. Your cancer treatment team can refer you to a fertility specialist to have discussions about your options as some may not be suitable for your cancer type or treatment plan. The fertility team will be able to advise as to what options are suitable for you, and whether they are funded or not.
Fertility preservation may include collection and preservation of oocytes (eggs) or ovarian tissue, ovarian preserving hormonal suppression, collection and preservation of sperm or testicular tissue. If you are to undergo surgery that may impact on your fertility, there may be surgical options that offer less risk.
It is important to note your cancer treatment may be delayed if you choose to undergo some types of fertility preservation, and you should discuss the likelihood and impact of treatment delays and any fertility treatments with your treatment team.
Ask about fertility as early in your journey as possible as this may mean you have more options for protecting or preserving your fertility.
Emotions and fertility
Discovering that you might not be able to have children can make you feel worried, sad, disappointed, or angry. For some people having children may have been a key part of their plans for the future and it can be devastating to learn this may not happen. Some people may experience grief at the loss of the potential to have biological children.
If you have a partner, they may also have similar feelings, a sense of loss or uncertainty.
If you feel this way, ask your treatment team or the Cancer Society information staff about counselling.
Once your treatment has ended you may wish to explore fertility options further. A good first step is to complete fertility testing to determine your current fertility status.
If you are fertile, depending on your treatment your doctor may recommend not attempting to conceive for a length of time after your treatment ends. This is to minimise the risk of treatment causing damage to the potential embryo.
If you have had fertility preservation treatment your fertility specialist can advise you on what your options are for conceiving a biological child.
If you are wanting to start a family and testing shows that you are infertile, ask your fertility specialist if any further options are available to you. You can also consult with social services/Oranga Tamariki to learn about further options available such as adoption.
Further useful information
For further information about fertility and fertility preservation we recommend the website of Fertility Associates.
For information specific for young people (adolescent and young adults) we recommend AYA Cancer Network Aotearoa.
Information about fertility after childhood cancers can be found on the Kids Health website.