Cancer therapies such as chemotherapy, radiation, and surgery have unequivocally saved millions of lives worldwide. Although these treatments are highly effective at targeting cancer cells, they are not without side effects that can impact other parts of the body, including fertility. Understanding why and how cancer treatments cause infertility, as well as how patients can mitigate the risks, is important for people going through treatment and for those thinking ahead to family planning. 

Can Chemotherapy and Radiotherapy Impact Your Fertility? 

• Chemotherapy: Chemotherapy is a widely used type of cancer treatment, and it works by targeting and killing rapidly dividing cells, which is a characteristic of cancer. But chemotherapy does not distinguish between cancer cells and other rapidly dividing cells in the body, like those in the ovaries and testes. In women, chemotherapy can harm the eggs within the ovaries, resulting in a diminished egg reserve or even lifelong infertility. In men, chemotherapy can also influence sperm production, decreasing sperm quantity or quality. The severity of this impact depends on the type, dose, and duration of the chemotherapy drugs used. 
• Radiotherapy: Radiotherapy is another cancer treatment that can cause infertility. When radiation is aimed at areas close to the reproductive organs, it can damage the ovaries in women or the testes in men. Regardless of target, young age and high-dose radiation use can affect normal organs even if radiation does not directly target such organs. In women, radiation can lead to premature ovarian failure (a form of early menopause); in men, it may impair sperm production or quality. 
• Surgery: Surgeries that affect the reproductive organs can have a direct influence on fertility. Surgery may require the removal of some or all reproductive organs if a tumor is present. These situations can immediately affect fertility. Even surgery that does not involve the reproductive organs can occasionally lead to scar tissue or other problems that may affect fertility. 

Why Do Cancer Treatments Cause Infertility? 

Cancer treatments such as chemotherapy and radiation therapy may affect fertility, as they can damage reproductive cells in both ovaries and testes. In women, chemotherapy and radiation can not only decrease the overall number of eggs available for fertilization but can also result in a complete loss of fertility in some women. Chemotherapy and radiation can affect sperm production or quality in men and hinder successful conception. 

Another important consideration is age. Younger people tend to have more eggs or sperm in reserve, which enhances their options for fertility preservation before treatment. But due to having fewer reproductive cells, older individuals are more susceptible to losing fertility. The impact on fertility depends on the timing of cancer treatment, the type of cancer, and which drugs or radiation are used. 

Fertility Preservation Options for Cancer Patients 

Luckily, there are multiple ways a person can attempt to preserve their fertility before beginning cancer treatment. Fertility preservation advances offer hope to many that they may still be able to have children in the future. 

For Women:

• Egg Freezing (Oocyte Cryopreservation): One of the most common recommendations for women is to freeze eggs prior to the start of treatment. This enables women to preserve healthy eggs so they will be ready for use should they decide to undergo fertility treatments in their later years. 
• Embryo freezing: This involves inseminating your eggs with sperm, creating embryos, and then freezing them. It is more successful than egg freezing because embryos fare better in the freezing process. 
• Ovarian Tissue Freezing: This is an option for women who cannot freeze either eggs or embryos. That includes harvesting and freezing ovarian tissue, which can then be implanted if and when someone is ready to have children. 

For Men:

• Testicular Sperm Banking: Men may freeze sperm prior to cancer treatment so viable sperm is available. A common technique for fertility preservation in men is sperm banking. 
• Testicular Tissue Freezing: For boys or men not yet producing sperm, testicular tissue freezing may be available. That tissue may one day be used to extract sperm. 

The Bright Side: Improvements in Fertility Treatments 

Fertility preservation techniques use the body itself, but significant advances in fertility treatments have been made as well, including in vitro fertilization (IVF) and using a sperm or egg donor. These treatments can help people who have lost their fertility from cancer treatment. Although the road to parenthood can be more complicated for some, many cancer survivors have gone on to create families due to these modern medical methods.

Furthermore, after finishing treatment, cancer survivors can often return to normal reproductive status as long as any initial subfertility due to treatment is only temporary. Improvements in personalized medicine, which customizes treatments for individual patients, are also reducing the risk of infertility in many therapies. 

Conclusion 

Cancer treatments, including chemotherapy, radiation and surgery, can sometimes make it impossible for a person to reproduce, but a growing field of fertility preservation now provides hope to many individuals who want to have children later. Therefore, individuals facing cancer treatments may not have to choose between a successful treatment and the opportunity to build a family. By understanding the risks associated with your cancer treatment and exploring options to preserve your fertility, you can make informed decisions about your reproductive health. Thanks to medical advancements in fertility preservation and treatment, many cancer survivors, including vaginal cancer still have options in terms of pursuing their dreams of parenthood.