I was treated for cancer as a child... Will I be able to have children?

Women who were treated for cancer during childhood and recovered can become pregnant and have children. What is important is taking the necessary precautions before treatment after the diagnosis is made.

When cancer is diagnosed in childhood or in young people who do not yet have children, “will I be able to have children?” is one of the first questions that comes to mind. It has long been known that fertility and/or reproductive capacity may be limited as a result of treatment in people who had cancer during childhood. Cancer treatment can reduce sperm count in men. In women, however, the situation is somewhat more complicated. The uterus and ovaries must perform their functions properly. A woman who wants to have children must have a healthy hormonal system and menstruate regularly. All these functions are affected by the treatment given to a person who had cancer during childhood. For example, many childhood cancers require radiotherapy. Radiotherapy applied to the pelvic region may affect the functional capacity of the uterus, or the ovaries may lose their ability to produce eggs. In addition, radiation applied to the brain may affect the hormones that regulate the ovaries’ cycle.

For this reason, one study examined fertility in women who had cancer during childhood and menstruated regularly during adolescence. Women who had cancer during childhood and were able to have children at the ages of 20-30 participated in this study. Women who had entered menopause, if any, were identified in order to understand ovarian function. Women who had not entered menopause were asked about unsuccessful attempts to become pregnant during the last 1 years. While signs of infertility were found in approximately %16 of all participants, it was determined that approximately %11 of participants in the control group showed signs of infertility compared with their sisters. In other words, it can be said that the risk of infertility is approximately %50 higher in women who received cancer treatment during childhood. Approximately %3 of these participants who had been treated for cancer as children and recovered were found to be menopausal. In addition, approximately %13 of women whose reproductive systems were functioning regularly and who menstruated were observed to be unable to become pregnant despite trying for 1 years. 2/3 of menstruating women became pregnant. This shows that women who had cancer during childhood can become pregnant, although it may take time.

Women who receive alkylating-agent chemotherapy (cyclophosphamide and nitrogen mustard) or radiotherapy to the abdominal or pelvic region may face infertility problems. This means facing problems such as early menopause and being unable to become pregnant. In addition, it is known that the risk of infertility is higher in girls who received cancer treatment during adolescence than in women who received cancer treatment during childhood. The recommendation in this regard is that women who are unable to become pregnant despite trying for 1 years should see an obstetrician-gynecologist.

In addition, regardless of whether a woman had cancer during childhood, the greatest risk of infertility is advancing age. Fertility begins to decline after the age of 35. It is important to know that this is also the case in women who have been treated for cancer and recovered.

Another important point is that women who were treated for cancer during childhood and recovered, have irregular menstrual periods, received radiotherapy to the pelvic or abdominal region, or received alkylating-agent chemotherapy and are unable to become pregnant despite wanting to should consult an obstetrician-gynecologist after 6 months.

Before cancer treatment, egg freezing is one of the best decisions that can be made. In this way, the female patient may be able to have children in the future. Sperm storage is easier in young men. However, the situation is somewhat more complicated in young girls. Some procedures, such as taking hormones, will be required to freeze the eggs. This delays cancer treatment by approximately 1-2 weeks. However, the aim of this procedure is to prevent limited ovarian function caused by cancer treatment from affecting fertility in the future.

A child being diagnosed with cancer, along with the question of whether the child will be able to have children in the future, is a very difficult situation for the family. In such a situation, it is important to consult specialist doctors such as a hematologist and/or oncologist, urologist and/or obstetrician-gynecologist in order to preserve the child’s fertility and make the right decisions, and to evaluate the situation together.

It is important for the family of a child or young girl newly diagnosed with cancer to remain in contact with specialist doctors. The aim here is for the patient to emerge from cancer treatment with the least possible harm. Fertility should be discussed beforehand, and a decision should be made regarding the necessary precautions after discussing the risk with the family according to the treatments to be administered.

Dear readers, as I mentioned in a previous article, cancer affects the sensitive nature of women very deeply. Regardless of their age, the health problems children experience will affect their future lives and reduce their likelihood of taking their place in society as happy and healthy individuals. For this reason, what the child may experience in the future should be examined closely, and the family should be enabled to make sound decisions by obtaining expert opinions.

Remember! Children are our future. We must protect them against all the difficulties they will face and raise them as healthy and happy individuals who are beneficial to society.