Receiving a cancer diagnosis as a young adult can be overwhelming. On top of processing treatment plans and survival outcomes, many face a deeply personal and life-altering question: Will I be able to have children in the future?
The truth is, some cancer treatments, such as chemotherapy, radiation, and surgery, can affect fertility. But thanks to advancements in reproductive medicine, fertility preservation is increasingly possible. With the right information and timely support, young adults can make empowered choices about their future family-building options.
Why Fertility Preservation Matters
For many young adults, the ability to have biological children later in life is an important part of healing, identity, and life planning. Cancer treatments may have an impact on reproductive function by:
- Damaging eggs, sperm, or reproductive organs
- Altering hormone production
- Triggering early menopause
- Causing temporary or permanent infertility
Fertility preservation provides options for people who want to safeguard their ability to become parents, either on their own, with a partner, or through surrogacy or donor programs in the future.
Common Cancer Treatments That Affect Fertility
Chemotherapy – Certain chemotherapy drugs can harm ovaries or testes, reducing or eliminating egg and sperm production.
Radiation Therapy – Pelvic or abdominal radiation can damage reproductive organs or affect hormone-regulating areas of the brain.
Surgery – Removal of reproductive organs or surrounding structures can permanently impact fertility.
Bone Marrow or Stem Cell Transplant – Often involves high-dose chemotherapy and radiation that carry a high risk of infertility.
When to Talk About Fertility
Fertility preservation should ideally be discussed before starting cancer treatment. According to medical guidelines, oncologists should offer a fertility consultation to all reproductive-age patients. However, not all healthcare teams initiate this discussion, so you may need to advocate for it.
Ask your doctor or care team:
- Will this treatment affect my fertility?
- What are my options for preserving fertility?
- Can I see a fertility specialist before starting treatment?
Fertility Preservation Options
For People Assigned Female at Birth:
Egg Freezing (Oocyte Cryopreservation)
- Mature eggs are retrieved and frozen for future use.
- Requires hormone injections and a short surgical procedure.
- Usually takes 2–3 weeks to complete.
Embryo Freezing
- Eggs are fertilized with sperm (from a partner or donor) and the resulting embryos are frozen.
- A more established option but requires a decision about using sperm.
Ovarian Tissue Freezing
- A portion of ovarian tissue is removed and frozen before treatment.
- Can be re-implanted later; useful for people who cannot delay treatment or are prepubescent.
- Still considered experimental in some cases.
Ovarian Suppression
- Medications (like GnRH agonists) are given during chemotherapy to temporarily “shut down” ovarian function.
- May offer some protection but is not a standalone method.
For People Assigned Male at Birth:
Sperm Banking (Cryopreservation)
- The most common and effective method.
- Requires masturbation to collect samples, ideally before treatment starts.
- Multiple samples can be stored for future use.
Testicular Tissue Freezing
- An option for prepubescent patients who cannot produce sperm.
- Still experimental but offers hope for future fertility.
Inclusive Considerations
Fertility preservation is relevant to all people with reproductive potential, regardless of gender identity or sexual orientation. Transgender and nonbinary individuals undergoing treatment should be offered affirming, inclusive options tailored to their needs, preferences, and transition plans.
Cost and Insurance
Fertility preservation can be expensive:
- Egg or embryo freezing may cost $10,000–$15,000 per cycle, plus annual storage fees.
- Sperm banking is more affordable, often around $500–$1,000, plus storage.
- Insurance coverage varies widely by state and provider.
Resources and assistance programs include:
- Livestrong Fertility
- The Samfund
- Hospital-based grants or financial aid
- Fertility clinics with discounted oncology programs
Emotional and Psychological Support
Deciding whether and how to preserve fertility is deeply personal and can stir up a range of emotions, from grief and fear to hope and relief. Support from:
- Oncology social workers
- Fertility counselors
- Mental health providers
- Peer support groups can make a major difference during this vulnerable time.
Key Takeaways
- Ask early: Fertility preservation is most effective when discussed before starting cancer treatment.
- Know your options: There are safe, science-backed ways to protect fertility for many young adults.
- Advocate for yourself: If fertility is not brought up, bring it up.
- You are not alone: Support, resources, and community are available.
Cancer may change the path to parenthood, but it does not necessarily close the door. With informed choices and compassionate care, young adults facing cancer can protect their dreams of having a family, whenever and however that future may come.
Citations.
National Institute of Health and Human Services
CDC
Empowering Intimacy
Live Strong
OncoFertility
LiveStrong Fertility