How Chemotherapy Affects Fertility

Woman waiting on home pregnancy test results

Chemotherapy can have the unintended side effect of harming a woman's ovaries, leading to a reduction or stopping of estrogen and progesterone production. The term for this is called chemo-induced ovarian failure, or CIOF. If hormone production is reduced or stopped, a woman may stop menstruating or she may have irregular periods. In addition, she may experience menopausal-like symptoms, like hot flashes or vaginal dryness and itching.

If a woman is not menstruating every month, she is not ovulating or releasing an egg every month. Therefore, she would not be able to get pregnant and is infertile at that time. 

Infertility Risk

Approximately two-thirds of women stop menstruating after starting chemotherapy for breast cancer, according to a study in Cancer Control.

Will Fertility Return?

In some women, their ovarian hormone production starts functioning again after chemotherapy. In other women, it does not and menopause begins at a younger age. Remember, just because you start having periods does not mean you are ovulating—you still may have difficulty or not be able to get pregnant. 

Whether or not a woman becomes fertile again depends on a lot of factors, according to the American Cancer Society. They include:

  • Type of chemotherapy used
  • Dosage of chemotherapy 
  • Age—women younger than 40 are at a lower risk of having chemo-induced ovarian failure than woman older than 40, according to a study in the Journal of the National Cancer Institute

Infertility Causing Drugs

The type of chemotherapy affects a woman's chance of developing infertility. For instance, cyclophosphamide (Cytoxan), cisplatin (Platinol), and doxorubicin (Adriamycin) are most likely to damage ovaries, according to the American Cancer Society. Methotrexate, 5-fluorouracil (5-FU), and vincristine have a low risk of damaging ovaries.

What to Do

Speak with your doctor about your personal risk of infertility before you undergo chemotherapy. Also, if you are considering pregnancy after chemotherapy, be sure to ask your doctor when this is possible. Usually, doctors recommend waiting six months after chemotherapy before attempting a pregnancy.

This may be a difficult time for you—having breast cancer at the prime of reproduction or simply before you are ready to be menopausal. Be informed so you can prepare yourself properly. Stay strong and get the support you need. 

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