Feelings about infertility

Feelings
Possible ways of preserving fertility

Feelings
Many people are devastated when they discover that the surgery, radiotherapy or chemotherapy treatment they need for their cancer will also mean they can no longer have any children. Infertility is very hard to come to terms with, especially if you were planning to have children in the future or to have more children to complete your family.

The sense of loss can be very painful and distressing. Sometimes it can feel as though you have actually lost a part of yourself. You may feel less masculine or less feminine because you can’t have children. Bodily changes, such as the menopause or inability to have an erection, may undermine your self-confidence even more.

People vary in their reactions to the risk of infertility. Some people may come to terms with it more quickly and feel that dealing with the cancer is more important. Others may seem to accept the news calmly when they start treatment, and find that the impact doesn’t hit them until the treatment is over and they are sorting out their lives again. There is no right or wrong way to react.

Who can help?

You may want to discuss the risks and all your options with your nurse or doctor before you start treatment.

You may also need an opportunity to talk with a trained counsellor about any strong emotions which threaten to become too much for you. See our database for details of helpful organisations.

Your partner will also need special consideration in any discussions about fertility and future plans. You may both need to speak to a professional counsellor or therapist specialising in fertility problems. They can help you to come to terms with your situation.

Your doctor may be able to refer you to a specialist or you can be put in touch with one directly by contacting a support organisation.

Possible ways of preserving fertility
There are a number of techniques that may help you to get pregnant or father a child, if cancer or its treatment have affected your ability to do this naturally. These need to be started before your treatment, so it is important to that you discuss the risk of infertility fully with your doctor before you start treatment. If you have a partner they will probably want to join you at this discussion. Then you can both be aware of all the facts and have a chance to talk over your feelings and the options for the future.

Women
It may be possible to collect and store some of your eggs for later use. Collecting eggs takes about 3–4 weeks and involves stimulating your ovaries with hormones, to produce more eggs than normal. The eggs are collected and then fertilised with sperm from your partner. The embryos are then frozen. When needed, the embryos are thawed and placed in the womb. Because this process takes a number of weeks, it may not be suitable if you have to start treatment straight away.

There is a risk with some cancers, such as breast cancer, that the hormones used to stimulate the ovaries may also stimulate the cancer to grow. It is possible to store unfertilised eggs but this is still an experimental procedure and much less successful. You may be charged a fee to store your embryos or eggs, and also for any fertility treatment that you decide to have.

It may be possible to remove small pieces of tissue from the ovaries before treatment. They can then be used in the future to achieve a pregnancy. The samples are frozen and stored until they are needed. This way of preserving fertility is still experimental and very few pregnancies have been achieved using this method. Only a few hospitals in the UK are able to store samples. Your doctor or specialist nurse can discuss this with you.

Teenage girls, who have started their periods, may also be able to collect and store eggs before treatment, in the same way. However, if the eggs are not fertilised before they are stored, the chance of a successful pregnancy will be very low.