Fertility preservation before cancer treatment

Overview

Fertility preservation is a set of steps you can take to protect your ability to have a child after cancer treatment. Some cancer treatments can harm your ovaries or testicles, which can make it harder to get pregnant or father a child. Fertility preservation means saving eggs, sperm, or embryos so you can try to start a family later.

It is becoming more common. Many large cancer centres now offer fertility preservation as part of routine care for people who might want children in the future.

It can affect anyone who is diagnosed with cancer and who may receive treatments that could harm their fertility. This includes women, men, and sometimes children and teenagers who have not yet gone through puberty.

Symptoms

Common symptoms

• Fertility preservation itself does not cause symptoms. It is a planned procedure, not an illness.
• You may feel some cramping or mild discomfort after egg collection, but it usually settles quickly.

Symptoms in children

• For children, fertility preservation is tailored to their age and stage of development.
• Parents or guardians will be involved in discussions about the best options.

Symptoms in older adults

• For older adults, fertility preservation may not be necessary if menopause has already occurred.
• Your care team can explain what options, if any, are still available.

Causes

Main causes

• A cancer diagnosis that requires treatment such as chemotherapy, radiation, or surgery.
• Treatments that directly damage the ovaries, testes, or the glands that control reproduction.

Risk factors

• Being of reproductive age when cancer treatment starts.
• Having certain types of cancer that require radiation to the pelvis or chemotherapy that affects fertility.
• Needing a stem cell transplant, which often uses very high doses of chemotherapy.

When to see a doctor

See a doctor urgently if:

• If you have just been diagnosed with cancer and will soon start treatment, ask your oncologist about fertility preservation right away.
• If your treatment is scheduled within days, you may still have time to preserve fertility — ask immediately.

Book a routine appointment if:

• If you are planning cancer treatment and want to know your options, request a referral to a fertility specialist.
• If you are not sure whether you want children in the future, it is still okay to ask for information.

Diagnosis

Fertility preservation is not a diagnosis. It begins with a chat with your healthcare team about your cancer treatment and your future goals. They may run tests to understand your current fertility.

Tests that may be done

• Blood tests to check hormone levels.
• An ultrasound to look at your ovaries.
• A semen analysis for people who produce sperm.
• A conversation with a fertility specialist about what to expect.

What to expect at your appointment

You will usually meet a fertility specialist who will explain your options, timing, and costs. They will work with your cancer team to make a plan that fits your treatment schedule.

Treatment

Fertility preservation is a planned procedure that saves your eggs, sperm, or embryos so they can be used later. The right option depends on your sex, your age, your cancer type, and how soon your cancer treatment must start.

Self-care at home

• Ask as many questions as you need.
• Write down the risks and benefits of each option.
• If you have a partner, talk about how you both feel.
• Take time to breathe and rest — you do not have to decide alone.

Medical treatments

For people with ovaries, the most common options are egg freezing, embryo freezing, and in some cases freezing a piece of ovarian tissue. For people who make sperm, sperm banking is a simple and effective choice. Sometimes, a medicine is given to reduce the effect of chemotherapy on the ovaries. Your healthcare team will explain which approach is safest for you.

When is surgery considered?

During some cancer operations, it is possible to remove and freeze ovarian or testicular tissue at the same time. This can be an option for people who cannot delay treatment or have not gone through puberty.

Living with this condition

After eggs or sperm are frozen, they are stored in a special facility. You will not feel them, and they do not change how your body works. You can continue with your normal life and focus on your cancer treatment.

Lifestyle tips

• Get plenty of rest, especially during cancer treatment.
• Eat a balanced diet and drink enough water.
• Try gentle activity like walking, as long as your care team approves.
• Avoid smoking and limit alcohol.

Diet and exercise

Aim for a diet rich in fruits, vegetables, whole grains, and protein. Exercise can help you manage stress, but always check with your cancer team before starting a new routine.

Mental health and emotional wellbeing

It is normal to feel a mix of emotions — hope, sadness, fear, or uncertainty. You may be grieving the possibility of having a child in a traditional way, even while feeling hopeful about fertility preservation. Talking to a counsellor can help. If you are feeling unsafe or need immediate help, contact your local emergency number or a local mental health crisis line.

Prevention

Fertility loss from cancer treatment cannot always be completely prevented, but preserving your fertility before treatment can improve the chances of having a child in the future. Early planning makes a big difference.

Vaccines

There is no vaccine that prevents fertility loss from cancer treatment.

Screening programmes

There is no routine screening test for fertility loss, but your healthcare team will assess your situation and recommend the most appropriate tests before starting preservation.

Complications

If left untreated

• If fertility preservation is not done before cancer treatment, some treatments may permanently reduce the ability to conceive.
• You may have fewer options for biological children later.

Long-term outlook

Many people successfully preserve their fertility and go on to have children after cancer. Even if preservation is not possible, there are other ways to build a family, such as donor eggs or sperm, surrogacy, or adoption. Your healthcare team can help you explore what is right for you.

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