Some treatments for bowel cancer carry a risk of infertility for women and men. Your healthcare team should discuss this risk with you when you are diagnosed.
Even if you’re not ready to have a child now, you might want the option to begin or grow your family 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 to a fertility specialist.
Both men and women should use contraception during radiotherapy and chemotherapy and for about a year after treatment ends. These treatments can damage sperm and eggs or harm a developing baby.
When you’re ready to start a family, you may need fertility treatment to have a baby.
Fertility in women
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) can often cause infertility and early menopause. Radiotherapy can affect the uterus and may affect your chances of having a successful pregnancy after 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. But having periods doesn’t always mean that you’ll be able to become pregnant. If your periods stop, they may return six months to a year later. Or they may stop permanently and you will go through the menopause.
The newer biological therapies may affect your fertility, depending on which drug you’re having. Your healthcare team can tell you how your treatment may affect your fertility.
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 will 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 cause too much of a delay to your cancer treatment. 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 still being tested and only a few babies have been born this way. It’s not available on the NHS and only a few clinics offer it.
Fertility in men
Surgery can cause erection and ejaculation problems, so may affect your fertility. Radiotherapy to the pelvis (area between the hips) 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 are more likely to have a low sperm count or stop producing sperm completely.
You’ll be offered the chance to store sperm before you start 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.
When you are 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.
Fertility Network UK has information on NHS funding for storing sperm, eggs and embryos and the costs of fertility treatment.
Join our online forum, a place for anyone affected by bowel cancer to talk about their experiences, share their knowledge and support each other.
Updated August 2018. Due for review March 2019.