What causes fertility problems after cancer treatment?

Fertility problems after cancer treatment can result from chemotherapy damaging eggs or sperm, affecting reproductive organs, or disrupting hormone signals. The effect depends on the medicines used, the treatment area, the dose and schedule, and a person's age and reproductive health before treatment.

Chemotherapy may reduce the number or quality of eggs or sperm. Some medicines can temporarily change reproductive function, while others may cause a longer-lasting reduction. Treatment involving the pelvis can affect the ovaries, uterus, testicles, or nearby tissues. Surgery may remove or alter reproductive organs. Radiation and hormone treatments can also interfere with the signals that support ovulation or sperm production. Fertility and the ability to have sex are different issues, so one may change without the other.

Tell your oncology team before treatment if having biological children may matter to you now or later. A fertility specialist can explain options such as storing sperm, eggs, or embryos when timing and health allow. After treatment, testing may assess hormone function, ovarian reserve, or sperm production. Do not stop cancer treatment or start supplements without medical advice; the safest fertility plan must fit the cancer treatment schedule.

Arrange a fertility review if treatment is planned, periods stop or change after treatment, erections or ejaculation change, or pregnancy has not occurred after you and your partner have tried for a period advised by your clinician. Seek urgent care for severe pelvic or testicular pain, heavy bleeding, fever, or sudden swelling. Your oncology team can coordinate fertility care without delaying attention to cancer symptoms.

Which part of my treatment may affect fertility? Is fertility preservation possible before treatment begins? When should hormone or sperm testing be considered? Could treatment affect pregnancy or sexual function? Who can refer me to a fertility specialist?