Reproductive Science Center of the Bay’s Sharing Hope Program, in partnership with Lance Armstrong’s LIVESTRONG Foundation, provides fertility preservation options for cancer patients whose treatment may jeopardize their future fertility.
The Sharing Hope Program provides reproductive information, emotional, and financial resources to cancer patients and survivors whose medical treatments present the risk of infertility. RSC provides both men and women several highly successful options for preserving their reproductive health and future parenting options.
Cancer & Fertility Overview
Cancer diagnosis and treatment itself is stressful enough for patients, then adding fertility planning on top of that can be overwhelming. Sharing Hope is a valuable resource intended to help ease the confusion and direct patients to the best fertility preservation services, as well as financing options for techniques that are not often covered by insurance.
Cancer treatments like chemotherapy are designed to kill rapidly dividing cells throughout the body, while leaving other cells intact. Cancer cells divide rapidly, but so do egg and sperm cells. Thus infertility is a potential side effect of cancer treatment.
Fertility Risks & Treatment Factors: Women (text below)
Fertility Risk & Treatment Factors: Men (text below)
Parenthood Options for Women (text below)
Parenthood Options for Men (text below)
Special Considerations for Breast Cancer, Genetic or Inheritable Cancers
Gynecologic Cancer, Pediatrics
Sharing Hope Financial Assistance
Fertility Risks & Treatment Factors for Women
Fertility Risks: Women
Cancer and its treatment may cause infertility and premature ovarian failure. Not all cancer treatments cause infertility, but some do.
Infertility is commonly defined as the inability to conceive after one year of regular unprotected intercourse but this definition does not always apply to cancer patients and survivors.
In addition to causing immediate infertility, cancer treatments can also cause you to go into menopause early. Premature ovarian failure is defined as menopause before age 40.
Women are born with a finite number of eggs and as you age, your supply of eggs naturally diminishes until you no longer have viable eggs left and you enter menopause. Cancer treatments like chemotherapy, radiation and surgery can speed up this process.
If your cancer treatments damage or destroy your entire egg reserve, you will be in menopause immediately after treatment. If you are in menopause, you are also infertile. Even if you are fertile after treatment, however, some portion of your egg reserve may still have been damaged. This reduction of your eggs means you will likely go into menopause earlier than you would have without cancer treatment, which makes family planning after treatment very important.
Risk Factors for Women
In women, cancer treatments can cause infertility. The following factors can influence your risk:
- Age at diagnosis or treatment
- Pre-treatment fertility status
- Type and dose of chemotherapy
- Location and dose of radiation
- Surgical area
Treatment Impact for Women
Chemotherapy, radiation and surgery
Chemotherapy, radiation and surgery can all affect your reproductive system. In general, the higher the dose and longer the treatment, the greater the chance for reproductive problems.
- Chemotherapy can damage or destroy your eggs. Your age, the type of chemotherapy, and the dose of the medications can influence your risk. Certain chemotherapy agents are more damaging than others.
- Radiation can also damage your reproductive system if it is directed toward your pelvic area. For example, radiation to or near your ovaries or uterus can cause infertility, but radiation to your chest will not. Radiation to your pituitary gland or hormone-producing areas of your brain can also cause infertility by interfering with your normal hormone production. In addition, radiation to your pelvic area can cause uterine damage, which may make it difficult to maintain a pregnancy. The location and dose of radiation will influence your risk.
- Surgery that removes all or part of the reproductive system can cause infertility. Removal of your ovaries, uterus, cervix or other reproductive organs can cause infertility. The location and scope of surgery will influence your risk.
- Bone Marrow & Stem Cell Transplants involve high doses of chemotherapy sometimes combined with full body radiation. Therefore, these procedures present a high risk of infertility due to ovarian and uterine damage.
- Gleevec® (imatinib) appears to have no effect on female fertility, however, it does not appear to be safe to be pregnant while taking Gleevec.
Fertility Risks & Treatment Factors for Men
Fertility Risks for Men
For men, infertility occurs when you stop producing sperm or when your sperm is too damaged.
The World Health Organization has developed criteria to measure the normal quantity, speed and shape of sperm.
- Sperm concentration (quantity) - More than 20 million sperm per mL of ejaculate
- Sperm motility (speed) - More than 50 percent moving sperm in ejaculate
- Sperm morphology (shape) - More than 30 percent of sperm in ejaculate have normal shape
- The average man has 60-80 million sperm per mL of ejaculate. Low or compromised fertility is defined as sperm concentrations of less than 20 million per mL of ejaculate, whereas sterility is generally defined as a complete absence of sperm.
Risk Factors for Men
Cancer can cause infertility in men. Some men with testicular cancer and Hodgkin's disease have low sperm counts when they are diagnosed and before treatment starts. This could be from the direct effects of the tumor or due to the stress of cancer.
Cancer treatments can also cause infertility. In general, the higher the dose and longer the treatment, the greater the chance for reproductive problems. The following factors can influence your risk:
- Age at diagnosis or treatment
- Type and dose of chemotherapy
- Location and dose of radiation
- Surgical area
- Pre-treatment Fertility Status
Treatment Impact for Men
Chemotherapy, radiation and surgery
Chemotherapy, radiation and surgery can all affect your reproductive system. In general, the higher the dose and longer the treatment, the greater the chance for reproductive problems.
- Chemotherapy kills rapidly dividing cells throughout the body - cancer cells and healthy cells. Your age, the type of chemotherapy, and the dose of the drugs can influence your risk. Certain chemotherapy agents are more damaging than others.
- Radiation also kills rapidly dividing cells in or around its target area. For example, radiation to or near your testicles can cause infertility, but radiation to your chest will not. Radiation to your pituitary gland or hormone-producing areas of your brain may cause infertility by interfering with your normal hormone production. The location and dose of radiation can influence your risk.
- Surgery that removes all or part of the reproductive system, such as one or both of your testicles, may cause infertility. Accordingly, the location and scope of surgery influences your risk.
- Bone Marrow & Stem Cell Transplants generally involve high doses of chemotherapy with or without full body radiation and, therefore, present a high risk of infertility.
- Gleevec® (imatinib) appear to have no effect on male fertility and it appears to be safe to father a child while you are taking Gleevec.
Parenthood Options for Women
There are more options now than ever before. Comparing factors like time requirements, success rates and costs will help you determine which options might be right for you.
Gestational Carrier or Surrogacy
Assisted Reproductive Technologies
Parenthood Options for Men
There are more options now than ever before. Comparing factors like time requirements, success rates and costs will help you determine which options might be right for you.
Assisted Reproductive Technologies
* RSC acknowledges Fertile Hope and LIVESTRONG Foundation for the information shared on RSC’s cancer and fertility web pages.
