Fertility and cancer

Why it helps to talk about having children in the future before cancer treatment starts.

Rosa: Hi, I'm Rosa. If you might want children someday, this is a good talk to have before treatment starts. Let's go over your options and the questions to ask.

Some cancer treatments can make it harder to have children later. This includes some chemotherapy, radiation near the pelvis or brain, hormone therapy, and surgery on reproductive organs. Not every treatment does this.

The best time to talk about fertility is before treatment starts. Some options take time, so ask early. Even if you are not sure you want children, it is worth asking. You can also ask for a referral to a fertility specialist.

Pregnancy during treatment can be risky for the baby. Ask your care team what birth control is safe for you. Also ask how long to wait after treatment before trying.

It is normal to feel rushed, worried, or sad when you hear that treatment might affect fertility. You may be making big choices at a very hard time. You do not have to decide alone. Take a moment to breathe, and ask the team to explain things again if you need to.

Every person's situation is different. How treatment affects fertility depends on the type of cancer, the treatment plan, your age, and your health. Your care team can explain what is likely for you. They can also tell you how much time you have before treatment needs to begin.

If you are a parent or caregiver of a child or teen with cancer, fertility matters for them too. Doctors can talk with you and your child about options that fit their age. Teens can be part of the talk in a way that feels comfortable for them.

Fertility questions do not end when treatment ends. Some people find that their fertility changes over time. Keep talking with your care team during follow-up visits. If you want to have a child later, ask what steps to take and who can help.

Options for people who make sperm

Sperm banking is simple and fast. It can often be done in a day or two before treatment starts.

Options for people who make eggs

Egg or embryo freezing usually takes about two weeks of hormone shots and a small procedure. Freezing ovarian tissue is another choice for some people. Medicines that rest the ovaries during chemo may also be discussed.

Cost and coverage

Fertility care can be expensive. A growing number of states require insurance to cover fertility preservation before cancer treatment. Some programs offer discounts. See Find help for groups that can help.

Questions to ask your team

Will my treatment affect my fertility? Can I see a fertility specialist before I start? How long can I safely wait? What are my choices if I cannot wait? Write your questions down and bring them to your visit.

Who can help

A social worker can help you cope and find resources. A financial navigator can help you look at costs and insurance. Your nurse can help set up a referral. A counselor can help you and your partner talk through hard feelings.

Other ways to build a family

If you cannot have a biological child, there are other paths. Some people use donor eggs, donor sperm, a surrogate, or adoption. You do not need to decide now. A counselor or specialist can explain what each choice involves.

Talking with a partner

Share your feelings and listen to theirs. You may not feel the same way at first. That is okay. Many couples find it helps to meet with a counselor together.

When to call your care team

Call if you think you may be pregnant, or if your birth control is not working or you missed a dose. Also call if you have questions about fertility before a treatment starts or changes. If you are unsure whether something matters, it is always fine to ask.

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.