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Talking about fertility: ask before treatment starts

Some chemotherapy, radiotherapy and transplants can affect the chance of having children in future. It is important to talk about this before treatment begins, because some options are only possible then.

Last updated: ~1 min read
A liquid-nitrogen storage container used to keep cells frozen
Figure 1.Cells are stored frozen in liquid nitrogen

01Short answer

Ask your team how your treatment may affect fertility, whether preservation options exist and whether there is time for them. Options include sperm banking for men, egg or embryo freezing for women and sometimes ovarian tissue preservation; some options for children are being studied. In acute leukaemia, delaying treatment is often not possible, and your team will then explain the options later on. Pregnancy should be prevented during treatment. Ask for a referral to a fertility specialist; emotional support matters too.

02Simple explanation

Ask early.

Preservation options.

A specialist referral.

During treatment: prevent pregnancy.

03Scientific explanation

NCI: cancer treatment can affect male and female fertility; preservation options should be discussed before treatment.

NCI: chemotherapy can lower neutrophils, platelets and red cells, which raises the risk of infection, bleeding and fatigue.

04What happens in the body?

Gonadotoxicity

Some medicines affect the ovaries and testes.

Time window

Some methods must be done before treatment starts.

Neutrophils

The first defence against infection; when they are low, hygiene matters most.

Platelets

Help blood clot; when they are low, protect yourself from injury.

05Daily protection: four steps

Wash, protect, check, report.

Wash — Hands and personal hygiene.1WashHands and personal hygiene.
Protect — Against injury and infection.2ProtectAgainst injury and infection.
Check — Temperature and skin.3CheckTemperature and skin.
Report — Tell your team about changes.4ReportTell your team about changes.
HygieneClean hands.
TemperatureThe 38 °C threshold.
ProtectionYour team's rules.

06Key points at a glance

TopicIn brief
GonadotoxicitySome medicines affect the ovaries and testes.
Time windowSome methods must be done before treatment starts.
NeutrophilsThe first defence against infection; when they are low, hygiene matters most.
PlateletsHelp blood clot; when they are low, protect yourself from injury.

07Key terms

Fertility
The ability to have children.
Cryopreservation
Storing cells or tissue frozen.
ANC
Absolute neutrophil count.
Thrombocytopenia
A low platelet count.

08Key points

  • Ask.
  • Choose.
  • Get support.
  • Wash your hands.
  • 38 °C: call.

09Frequently asked questions

Can I have children after treatment?

Many people can; your team assesses your chances individually.

Treatment has already started.

Ask anyway; there are later options and tests.

What should I watch every day?

Temperature, bleeding, tiredness and the catheter site; tell your team about any change.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Can I have children after treatment?

  2. Treatment has already started.

  3. What should I watch every day?

My questions

12Sources

  1. National Cancer Institute. Female Fertility and Cancer
  2. National Cancer Institute. Male Fertility and Cancer
  3. National Cancer Institute. Infection and Neutropenia during Cancer Treatment
  4. National Cancer Institute. Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment
  5. National Cancer Institute. Anemia and Cancer Treatment
  6. World Health Organization. World Hand Hygiene Day
  7. Macmillan Cancer Support. Infection
  8. Centers for Disease Control and Prevention (CDC). Preventing Infections in Cancer Patients
  9. American Cancer Society. Preventing Infections in People with Cancer
  10. National Cancer Institute (NCI). Depression (PDQ) – Patient Version
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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