Infertility is a man being unable to impregnate a woman or a woman being unable to conceive. Men are considered infertile if their testicles do not produce sperm, or if the pathways through which the sperm travels are blocked or removed due to testicular, prostate, or other forms of cancer. Women are considered infertile is their ovaries don’t produce eggs that mature, their reproductive system is damaged and thus cannot fertilize the eggs, or the fertilized eggs produced by the woman’s body cannot implant and begin to grow in the woman’s womb.

Not all of the cancer treatments will affect a man or woman’s fertility, but a number of them will. Any radiation treatment that is done in the pelvic region will often affect the fertility, as the area cannot be shielded from the radiation if it is the part being treated. Drugs will also affect the reproductive system, though many of the effects are only temporary. When parts of the endocrinal or reproductive systems have to be removed in order to prevent the spread of cancer, this too can cause problems with fertility. Age and health factors can also affect the outcome of cancer treatment and fertility.

In order to get pregnant, there are a number of factors that must be in place.

• A woman must have at least one of her ovaries, and it must be able to produce eggs that are healthy. That ovary must be connected to the womb via its fallopian tube, and the uterus must be healthy and able to hold the egg as it grows. There must also be enough of the hormones needed to maintain a pregnancy, at least until the placenta handles the task.
• Men must have at least one testicle that can produce healthy sperm, and the sperm must be able to mix with the semen and be ejaculated. They must also be able to produce the right hormones like testosterone.

It is only when some of these factors are off that pregnancy is impossible.

Before starting cancer treatment, it is always important to talk with the care team and physicians about preserving fertility. There are many fertility preservation methods that will have effect, and you would do well to talk to your doctor about which will be the best for you according to your age, health, and the type of cancer for which you are being treated.

Some important questions to ask your health care team before cancer treatment include:

• What, if any, effects will this treatment have on my reproductive system? Will the effects be long term, or will they be short term effects that will only last until the treatment is completed?
• Is there anything I can do to prevent infertility from being the result of my treatment? Do I need to do these things before the treatment starts, or do they happen during the treatment?
• Will any of the fertility preservation methods prevent my cancer treatment from being as effective as possible?
• In the case that infertility results from the treatment, what options do I have to start a family?
• How will I know whether or not I am fertile once my treatment has been completed?
• Is there a cancer fertility specialist who can help me find out as much as possible about fertility preservation before I undergo treatment?
• Is there a specific amount of time that I should wait between completing my treatment and trying to get pregnant?
• Can the treatments damage my ovaries to the point that I will lose all of my eggs or enter early into menopause?
• Will my cancer treatment have other negative effects on my body, such as causing heart problems, lung problems, and reproductive problems, to the extent that getting pregnant will no longer be safe and I may end up having trouble with a regular, full-term pregnancy?

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