Chemotherapy drugs are used for cancer treatment but can significantly affect your ability to get pregnant. Many factors impact your fertility after chemo. Discussing steps to preserve your fertility with your healthcare team is essential.

Share on Pinterest
FG Trade Latin/Getty Images

Chemotherapy is a powerful cancer treatment that often saves lives. But it can also have significant effects on your fertility. Certain chemo drugs are more likely to decrease the chances of getting pregnant after treatment.

You can take measures to preserve fertility before and during chemo treatment and increase your chances of having a baby in the future.

Learn more about chemotherapy.

The answer to this question is both yes and no. Some people will maintain their fertility or ability to get pregnant after chemotherapy. Other individuals will experience temporary infertility, but some will have permanent infertility.

The effects of chemotherapy on your ability to get pregnant depend on many factors, including:

  • type of cancer
  • specific chemotherapy drugs used
  • dosage of drugs used
  • length of treatment
  • age
  • menstrual history
  • hormone levels
  • amount of time since receiving chemo
  • overall health

The younger you are when treated for cancer, the better your odds of becoming pregnant after chemotherapy. People who receive treatment younger than age 35 will have the best chance of being able to conceive after chemo.

Chemotherapy can have adverse effects on your reproductive system. The primary injury it causes is damaging or destroying the rapidly dividing cells in your ovaries. Chemo can decrease the number of healthy eggs in the ovaries, leading to temporary or permanent infertility.

Which chemo medications don’t limit fertility?

Some chemotherapy medications have a lower risk of impacting your ability to get pregnant. Examples include:

  • 5-fluorouracil
  • 6-mercaptopurine
  • bleomycin
  • cytarabine
  • dactinomycin
  • daunorubicin
  • epirubicin
  • etoposide
  • fludarabine
  • gemcitabine
  • idarubicin
  • methotrexate

Which chemo medications may affect fertility?

Certain chemotherapy medications have a higher risk of affecting infertility. Alkylating agents, such as cyclophosphamide and busulfan, are among the most harmful to fertility. They cause more significant and permanent damage to reproductive cells.

Higher doses of drugs and combinations of drugs can have a more significant impact on fertility. If you’re treated with chemo and radiation therapy, the risk of permanent infertility is even higher.

A general recommendation is to wait 6–12 months to attempt pregnancy after chemo so that you can heal and avoid using an egg that started developing during chemo medication. Evidence indicates that getting pregnant before 1 year has passed can increase your risk of preterm birth.

Some individuals may have irregular periods during treatment, while others may temporarily or permanently stop menstruation. One study indicated that 31.6% of people experience their periods stopping, or amenorrhea.

Your periods returning after chemo will depend on several factors, including your age and the type and dosage of chemo given. Even if you have periods, it doesn’t mean you’re fertile. Evidence suggests that about 90% of people will resume having periods within 2 years of treatment.

After chemo, your menstrual cycles may not last as many years as they would without treatment. Your ovaries may stop making the hormones needed for fertility at a much younger age. This early end to menstrual cycles is called premature ovarian failure or premature menopause.

There are several options to preserve your fertility before starting chemo. One common approach is through egg retrieval and freezing, called oocyte cryopreservation.

Another option is to retrieve eggs and fertilize them in the lab with sperm, then freeze the embryos that are created.

None of the fertility preservation methods are perfect, and there are no guarantees they’ll work. Researchers continue to investigate additional ways to protect the ovaries.

The outlook for getting pregnant after chemotherapy varies for each person. Some may experience a return of fertility shortly after treatment. Other people may have challenges or permanent infertility.

It’s important to communicate openly with your doctors and consider consulting with a fertility specialist to explore the best options for getting pregnant after chemotherapy in your situation.

Can I explore alternative methods of conception if chemotherapy affects my fertility?

Yes, there are alternate methods of conception available. Assisted reproductive technologies such as in vitro fertilization (IVF) and egg donation provide options. Adoption and surrogacy are also alternatives for building a family.

Are there any lifestyle changes or supplements that can improve my fertility after chemo?

Having a healthy lifestyle can support fertility recovery after chemo. Regular exercise, a balanced diet, and avoiding harmful substances such as tobacco and alcohol can help overall reproductive health. Some people may also benefit from supplements such as folic acid and antioxidants.

Are there support groups or resources available for cancer survivors facing fertility challenges?

Yes, there are support groups and resources online and in person. Many cancer centers and fertility clinics offer counseling services and support groups.

While chemotherapy can affect fertility, it’s not always a permanent barrier to getting pregnant. The impact of chemo on reproductive health varies significantly between individuals. Advances in fertility preservation techniques offer hope to cancer survivors who wish to have children.