Monday 16 August, 2021

Approaching Fertility During and After Cancer

Related Stories

The topic of fertility is already sensitive as it is and adding cancer to the mixture doesn’t exactly make it easier. If you belong to the younger generation of fertile women and men affected by cancer, you may have experienced feelings and questions that have popped up…

“Am I going to be infertile now?” “Will I ever be able to have children?” “I want a family, what are my options now? ”What will my future look like?”

Unfortunately, because both fertility and cancer can be touchy and somewhat taboo subjects, there is often not enough information out there to help anyone who is going through cancer. Infertility is often taboo because the standard expectation is to have children (especially for women) and in many parts of the world, a woman’s worth is directly associated with her ability to bear children. There isn’t a lot of information out there about cancer and fertility, perhaps because the main objective when going through cancer treatment is to help us survive, and the risk of getting cancer increases dramatically after the age of 50 – that is, after the large majority have passed their reproductive years.

Yet, there’s still a significant group of people who are both fertile and have cancer. We deserve options and answers. We’ve got to start breaking the ice. 

We hope to send out a little clarity about cancer and fertility, whether you’re currently going through cancer, are living life with cancer, or are a loved one.

What we’ll cover:
What does cancer have to do with fertility?
IVF & adoption
Coping with infertility due to cancer
Communicating your needs to healthcare

What does cancer have to do with fertility?

Some cancer forms such as testicular cancer or cervical cancer, and different treatment forms such as chemotherapy, radiation therapy, surgery, bone marrow transplants or hormone therapy, can cause temporary or permanent infertility. Children or young adults who have been treated for cancer at a young age can also get affected by infertility due to the heavy treatment.

Whether or not fertility is affected depends on factors such as:

  • Your baseline fertility
  • Your age at the time of treatment
  • The type of cancer you have or treatments you undergo
  • The amount (dose) or length of treatment
  • The amount of time that has passed since cancer treatment
  • Other personal health factors

Going through cancer is heavily associated with loss of hair, being very sick, and even death. Yet, serious side effects such as infertility remain and are a reality after finishing treatment and in the clear.

Infertility doesn’t show on the outside but it feels on the inside and can be very heavy to carry and affect your mental health; it can be very frustrating when cancer stands in the way of plans and dreams of having children. For many, it means mourning loss and going through grief, a process that takes time and energy and perhaps doesn’t ever quite remedy. Not least, being around friends or others who have children can be difficult because it reminds us of the loss we are experiencing.

IVF and adoption

Since some cancer forms and treatments can cause infertility, some countries offer the possibility to maximize your chances of having a child in the future, through for example, freezing eggs, sperm, or embryos and saving them until after treatment to use through IVF (in vitro fertilization). IVF does not guarantee success but it does improve chances and give hope.

Science is constantly moving forward and a recent new study where transplantation of ovarian tissue was made has shown being successful too. Talk to your healthcare team about your options if you’re interested in freezing your eggs, sperm, or embryos – you can find some questions that may be worth asking later in this article. 

Another option is adoption. This may have been brought up by someone close to you or your healthcare team. It is an option that could interest many, and for good reason. If this is something you’re interested in, make sure you give it a go having informed yourself of the requirements necessary. The process to adopt a child is often long and complex, especially when cancer comes into the mix. Many adoption agencies require a medical history and a statement of health and having experienced cancer can make it more restrictive – in some cases, agencies require people who have gone through cancer to be five years cancer free before an adoption can occur. If you’re interested in this option.

Coping with infertility due to cancer 

Infertility can be challenging to live with – whether or not you know if you want to have kids or see it in your present or future, it’s the knowledge that you can’t necessarily make the choice you thought you had. In reality, the uncertainty of not knowing whether or not you can have kids is the case for virtually everyone, but specific cancer diagnoses or treatments make it harder to conceive and the uncertainty perhaps more certain. Facing this can be very hard to grapple with.

Yet, if cancer has taught us anything, it’s that no hope is lost. The odds may not be in our favour, but there is still hope. And if all odds are eliminated, still then, hope remains. Maybe it takes the shape of having your own children or looks differently altogether. There is always hope to reap joy in life, regardless of if it ends up looking like we planned or dreamed.

It’s hard to cope with the uncertainty or certainty about fertility and cancer. The best we can do is to not give up and find alternative ways if we desire to have children. When everything has been tried out and still nothing is working the best thing we can do is to try to accept, which is much easier said than done. 

Talk about how you feel with your loved ones 

It’s critical that you can share the thoughts you have about having your own children or building your own family with your partner, family or friends. If nothing else, it’ll help you make a bit of sense from your thoughts, feel less alone and supported throughout the process. Fertility or cancer or both can strain your relationship – if so, this article may help on how to strengthen your relationship during cancer. 

Connect with others who understand what it’s like 

If you’re struggling with feeling alone or isolated in your thoughts about fertility and cancer, find ways to connect with others who know what it’s like to go through what you’re going through. The War On Cancer app can be a great place to meet people with similar cancer diagnoses, age or demographic, and share stories. Together, we can build a tribe of people who can relate and encourage you, give tips, and simply know how challenging the road can be.

Write down what you’re experiencing 

Writing down your thoughts, feelings, and experiences can have a huge impact on your mental health and wellbeing (here’s more about how storytelling helps life with cancer). Whether you decide to share your story with others or keep them for yourself, it can prove an effective tool to release emotions, make sense of everything you’re thinking about, and gain clarity amidst the adversity. 

Get out of your own head 

When we face challenges and difficulties, we tend to ruminate, letting our minds get the best of us. A great way to remedy over-thinking is to get out of your thoughts and into reality – the here and now, the present. Whether that’s picking up creative outlets or getting out into nature, there are a multitude of ways to reconnect with yourself and the world around you and ease your mind from the thoughts that circulate. You may not know what that is and perhaps you have no desire to do anything and just go back to life before cancer. That’s understandable and normal. Cut yourself some slack and check out this article that may help you find or rediscover or create a way to repose from your thoughts and perhaps bring new light into your life.

Communicate your needs and desires to healthcare

It’s important that you feel in control throughout your experience with cancer. A part of this is learning about how your recommended cancer treatment may affect your fertility before starting. Ask your oncologist and don’t be shy to express and communicate your feelings about having children. Oncologists’ main focus is to treat cancer – they might need a reminder of what you wish for yourself and your future so that they can take that into consideration when creating the treatment plan.

Here are some questions from the National Cancer Institute to consider asking:

  • Could treatment increase the risk of, or cause, infertility? Could treatment make it difficult to become pregnant or carry a pregnancy in the future?
  • Are there other recommended cancer treatments that might not cause fertility problems?
  • Which fertility option(s) would you advise for me?
  • What fertility preservation options are available at this hospital? At a fertility clinic?
  • Would you recommend a fertility specialist (such as a reproductive endocrinologist) who I could talk with to learn more?
  • Is condom use advised, based on the treatment I’m receiving?
  • Is birth control recommended?
  • After treatment, what are the chances that my fertility will return? How long might it take for my fertility to return?

Make sure to talk with your healthcare team, share with your loved ones, and listen to yourself. You are not alone in it, and if you feel you are, download the War On Cancer app and connect and share with others who’ve been there.

Keep Reading

Get the latest War On Cancer articles

Share your story today, it will make a difference.