Cancer treatments may cause infertility and premature ovarian failure. Factors such as age, type of cancer and type of treatment can influence risk. Chemotherapy, radiation and surgery can all affect the reproductive system. In general terms, the higher the dose and/or longer the treatment, the greater the chance for reproductive problems for a cancer patient.

*Chemotherapy and Radiation: Many chemotherapy drugs will damage eggs (oocytes), depending upon the type and dose of chemo. Drugs most likely to cause infertility are alkylating drugs (cyclophosphamide) and nitrosources. Radiation can damage ovaries, whether it is directed to the abdomen, pelvis or brain. Radiation to the brain can affect the pituitary gland, which is responsible for hormone production.

*Surgery: As with men, surgery offers the greatest chance for cure for many types of cancer. These types of surgery may affect a woman's fertility:

• Hysterectomy (removal of uterus)
• Oophorectomy (removal of ovary/ovaries)
• Trachelectomy (removal of cervix, but not uterus) - a woman may still carry a pregnancy

*Hormone treatments- younger women are typical candidates for hormone therapy after chemotherapy ends.  In breast cancer cases, a five year course of tamoxifen may be prescribed.  It is best to discuss these types of treatments with a healthcare team, as they can affect fertility.

A reproductive endocrinologist (RE) and fertility specialist can work with your oncology team to provide you with important information about your fertility options and information about an infertility evaluation. Links for help in finding these health professionals in your area:

*American Society for Reproductive Medicine

 *Northwestern's Oncofertility Consortium's FERTLINE