Cancer Survivors and Infertility


Celebrating hope and life with survivors and their families, every first Sunday of June is International Cancer Survivors Day, and this year it will be observed on the 5th of June.

More and more people are diagnosed with cancer every year, and find themselves living with many kinds of consequences, one of which is often infertility. Our team at Cape Fertility proudly add our voice to raising awareness of cancer, including the range of reproductive cancers and the cancer treatments that negatively affect fertility, as well as the options available for cancer survivors who want to have children.

Cancer is one of the world’s leading causes of death, according to the WHO (World Health Organization). Despite the fact that all cancers can be treated, and many can be prevented or cured, a staggering 10 million people globally died of cancer just last year, and another 20 million people were diagnosed with cancer. In South Africa, CANSA estimates that one out of four people will be affected by cancer in their lifetime. It is expected that in the decades ahead, these numbers will continue to rise.

The WHO’s efforts are focused on breast cancer, now the most common cancer; cervical cancer, one of several reproductive cancers; and childhood cancer.

Having a reproductive cancer will certainly affect your fertility negatively. Unfortunately, it is not only reproductive cancers that affect fertility: any type of cancer and the resulting treatments are likely to contribute to – if not cause – infertility.

Fortunately for cancer survivors, there are ways to protect your fertility – with treatments ranging from fertility preservation options before cancer treatment commences, to advanced assisted reproductive treatments such as IVF (In Vitro Fertilization) with donor eggs or donor sperm; and ICSI (Intra Cytoplasmic Sperm Injection) – which allows even those men previously considered sterile to have a biological child; as well as further options such as surrogacy and adoption.

Let’s take a brief look at some of the reproductive cancers that will affect fertility; the impact of cancer treatments on fertility; as well as the treatments and options available to cancer survivors who want to start or build their family.

Reproductive cancers

Reproductive cancers start in the organs related to reproduction (sex) in the pelvis – the area in the lower belly between the hip bones.

Affecting both men and women, these reproductive cancers – as well as their treatments – can have a significant negative impact on fertility.

Among the most common reproductive cancers that occur in women include cervical cancer, ovarian cancer, uterine cancer, vaginal cancer and vulvar cancer. Breast cancer is sometimes also considered to be a reproductive cancer and is the most common cancer across the world.

Even though it is one of the most highly preventable and curable forms of cancer, cervical cancer is top on the list of the most common cancers. Nearly 600,000 new cervical cancer cases are diagnosed every year and more than 300,000 women die from cervical cancer each year.

Another deadly reproductive cancer is ovarian cancer, because it is often overlooked, misunderstood or misdiagnosed. Raising awareness of this cancer is therefore crucial, because the earlier a woman is diagnosed with ovarian cancer, the better her chance of survival.

Uterine cancer is cancer in the womb. Cancer can also occur in the vagina, and vulvar cancer affects the area around the opening of the vagina.

There are also different types of reproductive cancers that occur in men. The most common ones are testicular cancer, penile cancer and prostate cancer.

Cancer treatments

Sadly, it is not only these reproductive cancers that impact fertility: cancer treatments for all other types of cancer can harm reproductive organs and glands that control fertility.

The impact on fertility may be temporary or permanent, but only your oncologist will be able to confirm what you can expect, based on your specific treatment or treatments.

However, below are some common examples of how cancer treatments might affect fertility from the National Cancer Institute (NCI).

* Surgery for reproductive cancers as well as surgery for other cancers in the pelvis region, such as bladder, colon, prostate, and rectal cancer,

can damage reproductive organs and/or nearby nerves or lymph nodes in the pelvis and can cause scarring, leading to infertility in men and women. The size and location of the tumors are important factors in whether or not fertility is affected.

* Chemotherapy (especially alkylating agents) can affect the ovaries, causing them to stop releasing eggs and estrogen. This is called primary ovarian insufficiency (POI). Sometimes POI is temporary and menstrual periods and fertility return after treatment. Other times, damage to the ovaries is permanent and fertility doesn’t return. Chemotherapy can also damage sperm in men and sperm-forming cells (germ cells) in young boys.

* Radiation therapy to or near the abdomen, pelvis, or spine can harm nearby reproductive organs. In men, this treatment may destroy sperm cells and the stem cells that make sperm, lower sperm counts and reduce testosterone levels, causing infertility. For some types of cancers, the testicles can be protected from radiation through a procedure called testicular shielding. In women, the ovaries can be damaged, unless protected by ovarian shielding or by oophoropexy – a procedure that surgically moves the ovaries away from the radiation area. Radiation therapy to the brain can also harm the pituitary gland. In women, the pituitary gland signals the ovaries to make hormones such as estrogen required for ovulation. In men, radiation therapy can decrease the production of testosterone and sperm. The amount of radiation and area being treated both play a role in whether or not fertility is affected.

* Hormone or endocrine therapy used to treat cancer can disrupt the menstrual cycle, which will affect a woman’s fertility. In men, this type of treatment can decrease the production of sperm.

Fertility treatments for cancer survivors

Both men and women with any cancer diagnosis are encouraged to discuss the risk of infertility due to cancer and cancer treatments, as well as fertility preservation options, with their doctors as soon as possible – and before cancer treatment begins.

Thanks to advances in medical science, men and women facing cancer treatment can now choose to preserve and protect their fertility through options such as egg freezing, sperm freezing and embryo freezing.

However, even if you have already undergone cancer treatment and suffered damage to your reproductive organs, there are further options for having a baby. These range from advanced assisted reproductive treatments such as IVF (In Vitro Fertilization) with donor eggs or donor sperm; and ICSI (Intra Cytoplasmic Sperm Injection) – which allows even those men previously considered sterile to have a biological child; as well as surrogacy and adoption.

If you are interested in preserving your fertility, or if you are facing infertility following cancer treatment, it is important to see a reproductive or fertility specialist as soon as possible to determine which fertility option is the best for your unique situation.

At Cape Fertility, we value each individual patient and we look forward to providing you with our signature individualised and personalised care in the friendly, relaxed and caring environment you will find at our advanced, purpose-built facilities in the beautiful city of Cape Town.

Your next step is simply to contact us by clicking here… our highly qualified and experienced fertility specialists will gladly answer your questions and address any concerns you may have.