Key Points

• Cancer survivors who are infertile may still be able to become parents with the help of medical procedures and other alternatives, such as surrogacy and adoption.
  
  
• Talking with your doctor is the best way to learn more about your options.

Although infertility— the inability to start or maintain a pregnancy—can be a serious complication of cancer and cancer treatment, many cancer survivors may still be able to become parents. A wide range of procedures can preserve fertility, and other options, such as surrogacy or adoption, can be explored. Talk with your doctor to learn about your options and to find the information you need to make the best decision. This article is the second in a two-part series and discusses fertility procedures and other options for people with a history of cancer. The first part of the article explained how cancer treatment can affect fertility.

Considering having a child after cancer treatment is an exciting time, but it may also bring forth difficult feelings, such as anxiety, stress, and confusion. Talk with your doctor about your feelings and ask about support services available. Talking with another person or couple who completed one of the following procedures or considered other alternatives may also help.

Fertility options

Many fertility-preservation options need to be considered before cancer treatment, which is often not possible for many people with cancer since they need to receive treatment quickly. To learn more about fertility-preserving procedures to consider before or during treatment, read Fertility and Cancer Treatment. The options listed here may be explored after completing cancer treatment.

Options for women

Donor eggs. If cancer treatment damages a woman’s ovaries (where eggs are developed and stored) or causes early menopause (when no eggs are left), she may be able to use another woman’s eggs to become pregnant. After the eggs are retrieved, they are fertilized outside the womb by the sperm of a partner or donor in a process called in vitro fertilization (IVF). The fertilized eggs (embryos) are then transferred to the uterus of the woman who wants a child. A woman’s uterus must be healthy for her to successfully carry the pregnancy, and she may have to take hormones before and after receiving the embryos.

Egg donation allows at least one parent to have a genetic relationship to the child. All egg donors, whether they are a family member or friend or an anonymous or known donor from an agency, should be screened for psychological, medical, and genetic problems before they donate.

Donor embryos. Donor embryos usually come from couples who had an infertility treatment that resulted in extra embryos. A couple or individual who uses a donated embryo will not be genetically related to the resulting child, but the procedure allows an infertile woman with a healthy uterus to experience pregnancy. Sometimes, the doctor will instruct you to take hormones before and after the embryos are inserted. It is important to find out if the couple that donated the embryos underwent the genetic testing that is usually part of the egg donor process.

Surrogacy and Gestational Carriers: If a woman is not able to carry a child, or if becoming pregnant could put her health at risk, using a gestational carrier (another woman who carries the pregnancy) is an option. This procedure is called surrogacy if the cervix or uterus of a woman who is able to carry a pregnancy is injected with the sperm of the man who will be the child’s father in a process called artificial insemination. If the woman who is to carry the child is impregnated with an embryo created from another woman’s egg and her partner’s sperm, the woman who carries the child is called a gestational carrier. Surrogacy and gestational carrier laws are different in each state, so it is important to consult an attorney if you choose this option.

Options for men

Donor sperm. If a man who had cancer treatment did not store his sperm before starting treatment, he can use sperm donated to a cryobank (sperm bank) by another healthy male to become a father. In most cases, the sperm—which is screened for infectious diseases—is donated anonymously. However, cryobanks usually record the physical traits of the donor.

Testicular sperm extraction. Even if cancer treatment causes a man to have no sperm in his semen, he may still have healthy sperm in his testicles. During this surgery, the doctor removes small pieces of testicular tissue. Any sperm cells found in the tissue can be used in a fertility procedure or frozen for later use.

Adoption

If you do not want to undergo medical procedures to have a child or are uncomfortable with the idea of surrogacy, you may consider adopting a child. Adoption is the permanent, legal transfer of parental rights of a child from the birth parent to another couple or individual. Although most adoption agencies allow cancer survivors to adopt, some require a letter from a doctor certifying good health, and others may require a certain amount of time to pass after you have completed treatment for cancer.

Some of the adoption options to consider include:

Domestic adoption or intercountry adoption. A domestic adoption is adopting a child from the same country you live in. An intercountry adoption (also called international adoption) is adopting a child that lives in another country.

Open adoption or closed adoption. In an open adoption (also called a fully disclosed adoption), the birth parents and adoptive parents communicate. In a closed adoption, no identifying information about the birth parents or the adoptive parents is shared with either party.

Agency adoption or independent adoption. Many adoptions are handled by private agencies or public adoption agencies run by a county or state. These agencies are licensed and have strict regulations and rules to follow. Independent adoptions are handled by an adoption lawyer or facilitator instead of an agency.

Questions to ask your doctor

Consider asking your doctor the following questions when discussing your options to have a child after treatment for cancer.

General questions

• How do I confirm that I am infertile?
  
  
• Can you recommend a fertility specialist?
  
  
• Can fertility hormones or drugs cause my cancer to return or cause a new cancer to develop?
  
  
• Which infertility clinics specialize in treating patients who have had cancer?
  
  
• If I am infertile, what are my options for becoming a parent?
  
  
• How does my age affect these options?
  
  
• Where can I learn more about the cost of each option?
  
  
• Where can I find adoption resources or support?
  
  
• Where can I find surrogacy or gestational carrier resources or support?

Questions for women

• How can I find out if my eggs are healthy?
  
  
• How long after treatment do I need to wait before I attempt to get pregnant?
  
  
• Is my body healthy enough to handle a pregnancy?

Questions for men

• How can I found out if my sperm are healthy?
  
  
• How long after treatment do I need to wait before I help my partner get pregnant?

More Information

What to Know: ASCO's Guideline on Fertility Preservation

Pregnancy and Cancer

Additional Resources

American Cancer Society: What if I’ve Already Had Cancer Treatment and Didn’t Take Measures to Preserve My Fertility?

Child Welfare Information Gateway: Adoption

Comments? Got an idea for an article? Send an e-mail to contactus@cancer.net.

Last Updated: January 26, 2009