Fertility After a Cancer Diagnosis: What to Do First

Often yes, and the decision that matters most is made at diagnosis rather than after treatment. Chemotherapy and radiotherapy can damage eggs and sperm, and the reliable way to protect the option of biological children is to preserve eggs, sperm, embryos or ovarian tissue before treatment begins. Raise it with your oncologist as soon as you are diagnosed, even if you are unsure whether you want children. Deferring the conversation is the one choice that cannot be reversed later. The American Society for Reproductive Medicine committee opinion on fertility preservation covers the medical indications.

How does cancer affect fertility?

Two ways. The cancer itself, where it involves the reproductive organs, and the treatment.

Chemotherapy can damage eggs and sperm, with the effect depending on the drugs used and the dose. Radiotherapy affects fertility particularly where the pelvis is in the treatment field. Surgery may involve reproductive organs directly. Your oncologist can tell you what your specific regimen is expected to do, which is a more useful question than a general one.

What can be preserved before treatment?

Sperm banking

The simplest and fastest option. A sample is produced, processed and stored in liquid nitrogen, and it can usually be arranged within days, so it rarely delays the start of treatment. Where no sperm is present in the ejaculate, it may be possible to retrieve it surgically through TESA, PESA or TESE.

Egg freezing

Egg freezing requires a stimulation cycle of roughly two weeks, so the question is whether treatment can wait that long. That is a decision for your oncologist alongside the fertility team, not one to make alone. No partner or donor sperm is needed, so it leaves future decisions open.

Embryo freezing

The same stimulation cycle, with the eggs fertilized before freezing. It requires sperm at that point, and stored embryos generally require the consent of both parties for later use.

Ovarian tissue freezing

Ovarian tissue is removed surgically and frozen for later reimplantation. Its advantage here is significant: it does not require a stimulation cycle, so it does not delay urgent treatment, and it is the option available before puberty. Availability differs between centers, so ask where it can be accessed if it is being considered.

Why the timing is the whole point

Eggs and sperm are damaged by treatment as it happens. Preserving beforehand stores cells that have not been exposed. Afterwards, whatever damage has occurred has already occurred, and the options are much more limited.

If your treating team has not raised fertility preservation, ask. Being told there is no time is a legitimate answer in some situations, but it should be an answer you were given rather than an assumption nobody checked.

Our article on fertility preservation before medical treatment covers the options in more detail.

After treatment

Fertility is not always lost. Some people conceive naturally after cancer treatment. Where ovarian function has been affected, our article on premature ovarian insufficiency covers what that means.

Where material was stored beforehand, it can be used with IVF when your oncology team confirms it is appropriate to proceed. That timing is their decision, and it should be agreed with them rather than assumed.

We at Millennium IVF Clinic can discuss preservation options, and referrals before cancer treatment are time-critical. You can contact our team.

Frequently asked questions

Will cancer treatment definitely make me infertile?

No. It depends on the treatment, the dose and your age. Some people retain fertility. Preservation protects against an outcome that is uncertain rather than certain.

Will preserving fertility delay my cancer treatment?

Sperm banking rarely does. Egg or embryo freezing needs about two weeks. Ovarian tissue freezing does not require a stimulation cycle. Your oncologist and fertility specialist should decide together what is safe.

Can I preserve fertility after chemotherapy has started?

Options are much more limited, and anything collected has already been exposed. This is why the conversation belongs at diagnosis.

How long can eggs or sperm be stored?

Storage in Thailand is governed by the Protection of a Child Born by Medically Assisted Reproductive Technology Act B.E. 2558 (2015), which delegates the storage period to the Medical Council of Thailand rather than fixing one in the Act. Ask us what period applies and what you need to sign. Note that section 41 prohibits importing or exporting sperm, eggs or embryos, so material stored here cannot be moved abroad.