Fertility

Fertility

Fertility is your ability to have children. Some treatments for bowel cancer affect fertility for men and women. Your healthcare team should discuss this risk with you when you’re diagnosed.  

Even if you don’t want to have a child now, you may want the option to have children in the future.  

Coping with a cancer diagnosis as well as possible infertility can be hard. You might feel that things are moving very quickly with little time to make important decisions. Your healthcare team will give you support and can refer you to a counsellor and a fertility specialist. Both men and women should use contraception during radiotherapy and chemotherapy and for about a year after treatment ends. This is because these treatments can damage sperm and eggs or harm a developing baby. 

If you’re ready to start a family, you may need fertility treatment to have a baby. The Human Fertilisation and Embryology Authority has information on finding a clinic and fertility treatment options. 

Female fertility 

This section discusses fertility for women, trans men and other people assigned female at birth. 

There isn’t enough evidence to show how surgery for bowel cancer may affect fertility. Your healthcare team can give you information about how your treatment may affect your fertility. 

Radiotherapy to the pelvis (area between the hips) will often cause infertility and early menopause. Radiotherapy will affect the uterus and stop you having a successful pregnancy even with fertility treatment. Your healthcare team will explain your options, which may include surrogacy. 

Chemotherapy can cause temporary or permanent infertility, depending on the drugs and doses used. Your periods may continue during your treatment, or they may become irregular or stop. The younger you are, the more likely you are to carry on having monthly periods, or for them to return after treatment. However, having periods doesn’t always mean that you’ll be able to become pregnant. If your periods do stop during treatment, they may return six months to a year later. Or they may stop permanently, and you will go through the menopause. 
 

Biological therapies may also affect your fertility, depending on which drug you are having. Speak to your healthcare team if you are worried about this. 

Your fertility options will depend on how much time you have before your cancer treatment starts and how well you are. The chances of having a baby after fertility treatment vary from person to person. Your fertility specialist can give you an idea of how successful the different fertility treatment options are likely to be. 

If you have a partner, you may be able to have your eggs fertilised using in vitro fertilisation (IVF). This will take two to four weeks once you have been referred to a fertility specialist. The embryos can then be frozen and used once you’re ready to start a family. You’ll need your partner’s agreement before you can use the embryos. 

If you don’t have a partner, you may be able to store unfertilised eggs, which you can use in the future in fertility treatment. This procedure is less likely to result in a pregnancy than using frozen embryos. Some women use donated sperm so they can freeze embryos, rather than eggs. This isn’t funded by the NHS and may delay your cancer treatment. Speak to your healthcare team if you’d like to find out more about this. You can also find out more about these treatments and NHS funding from Fertility Network UK and the Human Fertilisation & Embryology Authority. 

Speak to your healthcare team if you’d like to find out more about this. NHS fertility clinics will usually freeze and store embryos and eggs for ten years. But in some parts of the UK, you may have to pay. 

If there isn’t time to freeze embryos or eggs before your treatment starts, you may be able to freeze tissue from one of your ovaries. This procedure is not widely available in the UK. Your healthcare team can tell you more about your options.  

Male fertility 

This section discusses fertility for men, trans women and other people assigned male at birth. 

Surgery can cause erection and ejaculation problems and so may affect your fertility. Radiotherapy to the area between the hips (pelvis) often causes infertility, depending on where the cancer is in your rectum. 

Chemotherapy can cause your body to slow down or stop the production of sperm. This can be temporary or permanent, depending on the drug and the dose. If it’s temporary, sperm production can take several years to fully recover. If you’re having more than one chemotherapy drug, you’re more likely to have a low sperm count or stop producing sperm completely. These treatments can also affect the production of testosterone in some men, but this is less common. 

You’ll be offered the chance to store some sperm before you start your treatment. The NHS may pay for sperm to be stored for ten years and sometimes for longer. Funding may depend on where you live. Your healthcare team can tell you more about this. Fertility Network UK and the Human Fertilisation & Embryology Authority also have information about funding. 

Before starting treatment, anyone considering having a family in the future should be given a chance to discuss their options.

If you’re transgender, you may have specific questions about fertility options available to you. Your clinical team should be able to answer these. 

Contraception

Both men and women should use contraception during radiotherapy and chemotherapy and for about a year after treatment ends. This is because these treatments can damage sperm and eggs or harm a developing baby. 

More information

Macmillan Cancer Support has information about protecting your fertility.  

Fertility Network UK has information on NHS funding for storing sperm, eggs and embryos and the costs of fertility treatment.  

The Human Fertilisation & Embryology Authority website has information on costs and funding of fertility treatment, and how to choose a fertility clinic.  

You can speak to people who’ve gone through similar experiences on our online forum. 

Updated July 2025  

Next review July 2028