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.
Fertility in women
Surgery may affect your fertility. Radiotherapy to the pelvis (area between the hips) usually causes infertility and early menopause.
Chemotherapy can cause temporary or permanent infertility, depending on the drugs and doses used. Your periods may become irregular or stop during treatment. The younger you are, the more likely you are to carry on having monthly periods. If the infertility is temporary, your periods may return six months to a year later. If the infertility is permanent, you may go through the menopause and your periods will stop.
The newer biological therapies may 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 are 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 would 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. You can find out more about NHS funding from Infertility Network UK and the Human Fertilisation & Embryology Authority.
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 is not available on the NHS and only a few clinics offer it.
Fertility in men
Surgery can cause erection and ejaculation problems and so may affect your fertility. Radiotherapy to the area between the hips (pelvis) usually causes infertility.
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 is temporary, sperm production can take several years to fully recover. If you are having more than one chemotherapy drug, you are more likely to have a low sperm count or stop producing sperm completely.
You will 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 a further ten years if needed. Funding may depend on where you live. Your healthcare team can tell you more about this. Infertility Network UK and the Human Fertilisation & Embryology Authority also have information about funding.
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.
When you are ready to start a family, you may need fertility treatment to have a baby. The Human Fertilisation & Embryology Authority’s booklet, Getting started: your guide to fertility treatment, has information on finding a clinic and fertility treatment options. They also have a search tool for choosing a fertility clinic, which gives details of which patients your chosen clinic treats, what treatments they offer and their success rates.
Beating Bowel Cancer has an online forum for people with bowel cancer, where you can discuss issues like fertility.
Human Fertilisation & Embryology Authority provides information on what happens at a fertility clinic and gives details of fertility clinics in the UK.
Infertility Network UK provides support, information and advice on fertility and NHS funding.
Updated March 2016. Due for review March 2018