How cancer treatment affects fertility
Chemotherapy agents differ in their effect on ovarian and testicular function; some are known to significantly reduce reserve while others are relatively sparing. Radiation to the pelvis, brain, or spine can affect fertility depending on dose and field. Certain surgeries — for gynecologic, urologic, or gastrointestinal cancers — can affect anatomy directly. The oncology team can usually estimate the level of expected risk based on the specific regimen.
Preservation options for people with ovaries
- Egg freezing — an accelerated stimulation cycle designed to complete in about ten to fourteen days, often started regardless of cycle day
- Embryo freezing — the same stimulation cycle, with eggs fertilized by partner or donor sperm before cryopreservation
- Ovarian tissue cryopreservation — a surgical option used in select patients, particularly children and patients who cannot delay treatment
- Ovarian suppression during chemotherapy — sometimes offered as an adjunct, though its effect on preserving fertility is still debated
Preservation options for people with testes
- Sperm banking — the simplest and most established option; multiple samples are ideal when time allows
- Testicular sperm extraction (TESE) — for patients unable to provide a sample or who have azoospermia, coordinated with a reproductive urologist
Working alongside the oncology team
The referring oncologist sets the timeline. In many cases a fertility-preservation cycle can be completed without delaying chemotherapy, though this depends on where you are in the diagnostic and staging process. Our team communicates directly with the oncology team so consultation, cycle start, and treatment start are aligned rather than competing for the same window.
Consent and long-term storage
Consent covers how eggs, embryos, sperm, or tissue may be used in the future — including disposition if you do not use them. Long-term storage arrangements and future-transfer planning are discussed up front. When appropriate, we coordinate with a gestational carrier program later on for patients who cannot carry a pregnancy after cancer treatment.