Certain chemotherapy regimens can lead to temporary or permanent infertility.

Chemotherapy is a cornerstone of cancer treatment, renowned for its ability to eliminate cancer cells. However, the potent drugs involved in chemotherapy do not discriminate between cancerous cells and other rapidly dividing cells in the body, including those in the ovaries and testes.

As a result, chemotherapy can significantly affect fertility and may lead to temporary or permanent infertility. This can add a layer of emotional and practical concerns for people of reproductive age.

It is crucial that people who are undergoing cancer treatment understand chemotherapy’s potential impact on fertility so they can make informed decisions about their reproductive future.

This article explores how chemotherapy affects the reproductive organs and what options people may have for preserving fertility. It also offers guidance for coping with infertility and considering other paths to parenthood.

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Chemotherapy can cause infertility in people of any sex. The treatment works by targeting rapidly dividing cells. Rapid division is a common characteristic of cancer cells, but chemotherapy also affects other rapidly dividing cells in the body, including those in the digestive system, hair follicles, and reproductive organs.

These effects can lead to temporary or permanent infertility, depending on several factors, such as:

  • the type and dosage of chemotherapy drugs
  • a person’s age
  • a person’s general health

Some people may experience temporary infertility, with their reproductive capabilities returning after treatment.

However, others may permanently lose the possibility of conceiving. Because of this risk, it is crucial that people discuss fertility preservation options with their healthcare team before starting chemotherapy if they think they may want to conceive a child in the future.

Learn more about chemotherapy.

Chemotherapy can significantly affect the ovaries, potentially leading to temporary or permanent changes in reproductive function.

The ovaries contain a limited number of eggs, and certain chemotherapy drugs can reduce both the number of eggs and their quality. This damage can lead to irregular menstrual cycles or amenorrhea (the complete stoppage of menstruation). Because oocytes (egg cells) tend to divide quickly, they are particularly susceptible to the effects of chemotherapy.

The ovaries may be more resilient in younger people. Typical ovary function might resume after treatment, leading to a return of menstrual cycles and the possibility of conception.

However, in people who are older and those who receive higher doses of chemotherapy, the damage may be more extensive. People may experience premature ovarian failure, meaning that the ovaries no longer produce eggs or the hormones necessary for reproduction.

Chemotherapy can also affect the testes, potentially leading to temporary or permanent changes in sperm production and quality.

The testes produce sperm and testosterone, a hormone that is crucial for male reproductive health. Chemotherapy drugs can damage the sperm-producing cells in the testes, resulting in a reduced sperm count or azoospermia (the absence of sperm).

Younger males may find that their sperm production recovers after chemotherapy treatment, although this recovery may take many years. There is no guarantee that typical sperm production will return, and some people may experience permanent infertility due to irreversible damage to the testes.

Temporary infertility can occur if potent chemotherapy drugs disrupt fertility during cancer treatment. However, a person’s fertility can return after the treatment ends.

For males

Chemotherapy can cause temporary infertility by reducing sperm production. Chemotherapy drugs can damage the sperm-producing cells in the testes, leading to oligospermia (low sperm count) and reduced sperm quality.

Oligospermia can significantly affect a person’s ability to fertilize an egg both during and shortly after treatment. However, sperm production may improve over time as the effects of the chemotherapy decrease.

Regular semen analysis can help track the progress of a person’s recovery and determine when it may be safe to attempt conception.

For females

Chemotherapy can disrupt the menstrual cycle and reduce ovarian function, leading to temporary infertility.

Many people notice that their menstrual cycles return after chemotherapy ends, and this indicates that ovarian function is beginning to recover. The recovery process can take several years, and the likelihood of regaining full reproductive function varies from person to person.

Even if menstrual cycles resume, people should undergo ovarian reserve and hormone level assessments to determine their potential for conceiving.

The permanent loss of reproductive function is a serious concern for people who are undergoing chemotherapy. This can happen if chemotherapy drugs cause lasting damage to the reproductive organs, preventing the possibility of conception.

As with temporary infertility, a person’s chances of experiencing permanent infertility depend on factors such as the type and dose of chemotherapy drugs, the person’s age, and their overall health.

For males

Chemotherapy can cause permanent infertility if it leads to irreversible damage to the testes. This damage can result in a permanent reduction or absence of sperm production.

For females

Permanent infertility can occur if chemotherapy causes extensive damage to the ovaries, leading to premature ovarian failure. This condition results in a permanent loss of eggs and an inability to conceive.

Higher doses of chemotherapy and combined drugs are more likely to cause permanent changes to fertility. The risks increase when a person receives both chemotherapy and radiation therapy to the abdomen as part of their treatment regimen.

Preserving fertility before undergoing chemotherapy can allow people to maintain their reproductive potential.

Various options are available to safeguard reproductive cells and tissues and allow for the possibility of conception in the future. The choice of preservation method depends on individual circumstances, including age, health, and the type of chemotherapy treatment.

For males

Males can consider sperm banking before starting chemotherapy. This process involves collecting and freezing sperm for future use.

Another option for people who have not gone through puberty and are at high risk of infertility is testicular tissue freezing. It is still experimental but shows promise for preserving fertility.

For females

Females can preserve fertility through the following techniques:

  • Egg freezing: This process involves removing and freezing mature eggs. Healthcare professionals can later thaw and fertilize these eggs to form embryos.
  • Embryo freezing: Embryo freezing involves removing eggs, fertilizing them with sperm to form embryos, and then freezing them. Healthcare professionals can later place the thawed embryos in a person’s uterus.
  • Gonadotropin-releasing hormone agonist: This treatment stops egg maturation and hormone production. It protects against premature ovarian failure in breast cancer.
  • Ovarian tissue freezing: This process involves surgically removing and freezing ovarian tissue. Healthcare professionals can reimplant thawed tissue later.

Before a person starts chemotherapy, it is important that they understand their specific chemotherapy regimen and its potential side effects. People may also want to learn about fertility preservation options. This knowledge will allow them to anticipate changes in their physical and emotional well-being and to plan accordingly.

Preparing for possible chemotherapy side effects, such as fatigue, nausea, and hair loss, by arranging support systems and practical assistance can make the treatment more manageable.

Financial considerations are also significant, as the cost of chemotherapy and related medical expenses can be substantial. Reviewing insurance coverage, exploring financial assistance programs, and discussing costs with healthcare professionals can help alleviate financial stress.

After completing chemotherapy, people should consult their healthcare team before trying to conceive. It is crucial to ensure that a person’s body has recovered and to assess their fertility status before they start trying to conceive.

Other options

People who cannot conceive on their own after chemotherapy may want to consider an option such as using donor sperm or eggs or pursuing adoption. These alternatives may provide pathways to parenthood for people who are experiencing infertility.

Coping with infertility can be emotionally challenging. Seeking support from mental health professionals, joining support groups, and talking openly with partners and loved ones can help people navigate the emotional aspects of the experience.

A person may be able to find emotional support and practical advice by connecting with others who are facing similar challenges. For support and information, people can contact Resolve: The National Infertility Association.

Chemotherapy can affect fertility either temporarily or permanently.

Understanding chemotherapy’s effects on the reproductive organs and exploring fertility preservation options can help people manage their reproductive future.

Seeking support from healthcare professionals, nonprofits, and loved ones can help a person cope with infertility and explore alternative paths to parenthood.