Fertility after chemotherapy or radiotherapy

Your ovaries might start working weeks, months or years after finishing chemotherapy or radiotherapy. It’s also possible that your fertility might never recover, and you’ll remain infertile.

If you're in a relationship where it's possible to get pregnant, it's important to use contraception until it's safe and you're ready to get pregnant. You should use contraception even if your periods stopped during or after treatment.

Checking your fertility after treatment

You'll have the option to be seen in our follow-up clinic to assess your ovarian function after completing your main treatment. This can help you make an informed decision about your future fertility plans.

In the appointment, we'll assess your menstrual cycle and ovarian function. We'll check and tell you about how much your treatment has affected your future ability to get pregnant naturally. It might be that you have a reasonable egg reserve left and nothing needs to be done to help you conceive naturally. Or, if your treatment has affected your natural ability to conceive and you had fertility preservation treatment, we'll give you advice about how to proceed with using your stored eggs, embryos or tissue when you are ready. 

We'll be happy to see you and give you an assessment even if you're not trying to have a baby at the time. As your ovarian function might take several months to recover, we recommend that you wait for 1 year or more before having an assessment. 

Having a baby naturally

If your fertility recovers, you can choose to try to have a baby naturally. Your cancer should not affect the health of your baby.

Having a baby with fertility treatment

If you have issues with getting pregnant, you can return to us to discuss your options and if any fertility treatment might be appropriate and possible.

At the moment, there’s no special funding for fertility treatment for couples where either partner has previously had cancer. The eligibility criteria for funding are the same as for any other person seeking fertility treatment. If you do not meet these criteria, fertility treatment will have to be self-funded.

Using frozen eggs, embryos or ovarian tissues

If you have eggs, embryos or ovarian tissues stored, you can choose to use them through the fertility unit at Guy’s Hospital.

You’ll be advised on the best procedure, which could include:

• egg thaw, fertilisation with intra-cytoplasmic sperm injection (ICSI) and embryo transfer
• transplantation of ovarian tissues
• IVF (in vitro fertilisation)
• intra-cytoplasmic sperm injection (ICSI)

We'll need to apply for your NHS funding again when it comes to using previously stored eggs or embryos. There is no special funding for fertility treatment for couples where either partner has previously had cancer. The eligibility criteria for funding are the same as for any other person seeking fertility treatment. If you do not meet these criteria, fertility treatment has to be self-funded.

If you didn't have fertility preservation

If you weren't able to freeze eggs, embryos or ovarian tissues, and your main treatment caused no eggs left in your ovaries, you might want to consider using donated eggs or adoption.

This can often be a difficult decision, but your team can talk to you about this in detail and provide you with the support you need to make a decision.

The HFEA has more information about using a donor.

Issues related to fertility after cancer treatment

We offer long-term follow up after chemotherapy or radiotherapy has finished. We work with your oncologists or doctors to give you help for different conditions you might have after treatment.

Early menopause

Sometimes ovaries never recover. This is known as premature ovarian insufficiency (POI).

You might have symptoms such as hot flushes, night sweats and sleep disturbance. This can be treated with hormone replacement therapy (HRT).

You can read more about early menopause on the NHS website.

Problems with sex

We offer long-term follow-up if chemotherapy or radiotherapy has affected your ability to have sex, or your enjoyment of sex.

Problems can include:

• low sex drive
• discomfort or pain
• problems with arousal

It can be difficult to talk about some of these issues, or you might feel embarrassed to discuss this with your doctor after cancer therapy. Please speak to the specialist nurse or the fertility doctor at our clinic, as help is available.