The short answer
Some cancer treatments can lower fertility or cause infertility, and changes may be temporary or permanent. NCI encourages talking with your doctor — and a fertility specialist — before treatment starts if having a biological child may matter to you one day. There are preservation options for both women and men.
Cancer treatments can cause infertility or lower fertility by harming reproductive organs or the glands that control fertility.
Changes to fertility may be temporary or permanent — it depends on the treatment, the dose, your age, and other factors.
NCI advises talking with your doctor and a fertility specialist before treatment if having a biological child may be important to you.
Research found survivors were less regretful if they met with a fertility specialist — whatever they decided.
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The full explanation.
The simple version
Fertility is the ability to have children. Some cancer treatments lower fertility. Some cause infertility. Sometimes this is temporary. Sometimes it is permanent.
Does having a biological child one day matter to you? Raise the topic with your doctor before treatment begins. The National Cancer Institute encourages this. Sometimes you may need to be the one to start that conversation.
Thinking about fertility can feel overwhelming. You and your team are focused on planning cancer treatment right now. But research has found that survivors felt less regret if they had met with a fertility specialist. That held true whether or not they decided to preserve their fertility.
What affects whether fertility changes
It depends on several things.
- The type of treatment, the dose, and how long treatment lasts.
- Your age at the time of treatment.
- How much time has passed since treatment.
- The type of cancer, and whether the tumor is near reproductive organs.
- Your fertility before treatment, and other personal health factors.
How treatments can affect fertility
Cancer treatments may harm reproductive organs. They may also harm the hormone glands that control fertility. Changes may be temporary or permanent.
- Chemotherapy destroys cancer cells. It can also harm healthy cells. That includes egg cells in the ovaries, and the cells that become sperm. Some drugs, such as alkylating agents, pose a high risk. Higher doses raise the risk further, and so do several drugs at once. In women, chemotherapy can lead to primary ovarian insufficiency. The ovaries then stop developing mature eggs and producing estrogen.
- Radiation therapy to the reproductive organs or pelvic area can damage ovaries, eggs, or sperm-forming cells. Radiation to the brain can affect the glands that make hormones needed for fertility. The dose, the body area treated, and your age all play a role.
- Hormone therapy can cause primary ovarian insufficiency in women. It can decrease sperm count in men.
- Surgery that removes reproductive organs can cause infertility. Examples are a hysterectomy, or removal of both ovaries or both testicles. Surgery in the abdomen or pelvis can also affect nearby organs and nerves.
- Stem cell transplant usually involves high doses of chemotherapy, radiation, or both. These can damage ovaries or sperm-forming cells.
- Immunotherapy and targeted therapy. Their effects on fertility are still being studied. Ask your doctor what is known about your specific drug.
Fertility preservation options
Fertility preservation means saving or protecting eggs, embryos, sperm, or reproductive tissue. This may let you have biological children in the future. NCI describes these options.
- For women and girls: embryo freezing and egg freezing. Also ovarian tissue freezing, an option for girls who have not gone through puberty. Also ovarian shielding during radiation. And ovarian transposition — surgery that moves the ovaries away from the area receiving radiation.
- For men and boys: sperm banking, the most common method after puberty. Also testicular shielding during radiation. And testicular sperm extraction.
Say you choose to preserve fertility. Your cancer doctor and a fertility specialist then work together on a plan. That plan covers whether any delay to the start of treatment is safe. Success rates, costs, and availability vary. Many hospitals have patient navigators. They can help you find fertility resources and financial support.
Birth control still matters during treatment
Even when treatment lowers fertility, there may still be a chance of pregnancy. Some treatments can harm a pregnancy. Some can cause miscarriage. So your doctor may advise using birth control during treatment, and sometimes for a period afterward.
You get to decide what matters
Many people want children someday. Others do not. Others plan to build families in different ways. NCI's advice is to make decisions that reflect what is important to you. Lean on your health care team, fertility specialists, and support groups along the way.
Words to know
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Common questions
Which cancer treatments can affect fertility?
Chemotherapy, radiation therapy, hormone therapy, surgery, and stem cell transplant can all affect fertility. For example, some chemotherapy drugs (like alkylating agents) pose a high risk, and radiation to the reproductive organs, pelvis, or brain can also affect fertility. The effects of immunotherapy and targeted therapy are still being studied.
Are fertility changes from treatment permanent?
Not always. Changes may be temporary or permanent. It depends on factors such as the type and dose of treatment, how long it lasts, your age at the time, and how much time has passed since treatment. Your doctor can help you understand what to expect for your specific treatment.
What fertility preservation options exist?
For women and girls, options include embryo freezing, egg freezing, ovarian tissue freezing, ovarian shielding during radiation, and ovarian transposition (surgery to move the ovaries away from the radiation area). For men and boys, options include sperm banking, testicular shielding, and testicular sperm extraction. A fertility specialist can explain which options fit your situation.
Why would I need birth control if treatment lowers fertility?
Even though cancer and its treatments can lower fertility, there may still be a chance of pregnancy. Because some treatments could harm a pregnancy or cause miscarriage, doctors may advise using birth control during treatment.
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Last updated: 2026-08-11Next planned review: 2027-02-03
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How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes. We do not employ clinicians and do not intend to — our work is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and checked line by line against the sources listed on it. That confirms the sources support what the page says. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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