NCCN Guidelines for Patients
Adolescents and Young Adults with Cancer, Version 1.2017
Preparing for the future
Can I have children after cancer treatment?
If your treatment plan includes medication or
procedures that can have an effect on your fertility,
work with your doctor and a reproductive specialist to:
Limit the damage from treatment.
Learn steps you can take so you can still have
children in the future.
Understand what your fertility options
may be after treatment is complete.
Once you know what you want to do, let your doctor
know what your plans are for children. Your doctor will
take time to look into your case—including the risks
of delaying treatment—to make a decision about the
timing of fertility preservation.
Understanding the risks
The complete loss of the ability to have children is
In men, infertility happens when the testicles can
no longer make sperm (a condition known as
azoospermia) or when the pathways that sperm travel
through are blocked or damaged.
In women, infertility happens when:
The ovaries can no longer make eggs, a
condition called premature ovarian failure or
There is damage to the uterus (where babies
grow during pregnancy) or other parts of the
reproductive system so the eggs can’t get
There is damage to the uterus or other parts
of the reproductive system so fertilized eggs
can’t implant and grow inside the uterus.
The actual risk of infertility varies depending on the
cancer, the treatment, treatment dose, and the age
of the person getting cancer treatment. In general,
the higher the dose and the older your age, the more
likely you are to experience problems.
Treatments can harm the reproductive system. This
depends on the area the treatment is given to and
how much (the intensity or combination of drugs) are
given. Treatments that affect the reproductive area
High-dose or targeted radiation to places like
the pelvic area.
Chemotherapy that includes a type referred to
as alkylating agents.
Surgery to remove tissue or organs from the
It is important for AYAs to think about fertility
preservation early on. Still, today it is one of the
least-thought-about services for AYAs. Sometimes
it is not an option to look into fertility preservation
early on due to an urgent need for treatment. If this
is the case, you can still talk to your doctor about
preservation after treatment starts.
My wife is pregnant and I’ll be having my
first child almost six years after I was
first diagnosed. And it’s all because my
doctor and I talked about fertility on day
Hodgkin Lymphoma Survivor
Age at diagnosis: 31