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26

NCCN Guidelines for Patients

®

Adolescents and Young Adults with Cancer, Version 1.2017

3

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

called infertility.

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

early menopause.

††

There is damage to the uterus (where babies

grow during pregnancy) or other parts of the

reproductive system so the eggs can’t get

fertilized.

††

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

may be:

††

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

reproductive area.

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

one.”

- Bret

Hodgkin Lymphoma Survivor

Age at diagnosis: 31