LGBTIQA+ people and cancer

Fertility after cancer

Overview

How cancer affects your fertility depends on the type of cancer, the treatment you’ve had, and your age.

You can discuss fertility with your cancer care team before treatment starts. There are ways to preserve fertility such as freezing eggs or sperm.

After treatment, there are many ways to approach conceiving a child, though you may have to wait up to 2 years before trying to get pregnant.

LGBTIQA+ people and cancer booklet (PDF)

About this information

The information on this website is not medical, legal or financial advice. Always consult appropriate professionals about your specific situation. Full disclaimer.

Reviewers

This resource was developed as part of the Western Sydney University Out with Cancer research project. This edition has been developed by Cancer Council NSW on behalf of all other state and territory Cancer Councils as part of a National Cancer Information Subcommittee initiative.

We thank the reviewers of this edition:

Prof Alison Brand, Clinical Professor, The University of Sydney and Director, Department of Gynaecological Oncology, Westmead Hospital, NSW; Dr Daniel Brown, Clinical Psychologist and Researcher, School of Psychology and Public Health, La Trobe University, VIC; Dr Rosalie Power, Senior Research Fellow and Deputy HDR Director, Translational Health Research Institute (THRI), Western Sydney University, NSW; Dr Sarah Bishop Browne, Palliative and Supportive Care Staff Specialist, Chris O’Brien Lifehouse, NSW; Collette Butler, Clinical Nurse Consultant and McGrath Breast Care Nurse, Cancer Support Centre, Launceston, TAS; Prof Ada Cheung, Endocrinologist, NHMRC and Dame Kate Campbell Research Fellow and Head, Trans Health Research Group, The University of Melbourne, VIC; Dr Tiffany Daly, Radiation Oncologist, Princess Alexandra Hospital, Raymond Terrace, QLD; A/Prof Ian Faragher, The University of Melbourne and Head, Colorectal and General Surgery Unit, Western Health, VIC; Hall & Wilcox (law firm); A/Prof Peter Heathcote, Urologist, Brisbane Urology Clinic, QLD; Prof Richard Hillman, Senior Staff Specialist, HIV and Immunology, St Vincent’s Health Network, Sydney, NSW; Mads Kennedy, Project Coordinator, Silver Rainbow, LGBTIQ+ Health Australia, NSW; Dr Sanjeev Kumar, Breast Cancer Medical Oncologist and Clinician Scientist, Chris O’Brien Lifehouse, NSW; Madeline Lee, 13 11 20 Consultant, Cancer Council NSW; Luke Mitchell, Urological and Sexual Health Nurse Practitioner, Men’s Health Melbourne, VIC; Nadia Reddish, Consumer; Dr Stephen Rowles, Sexual Health Physician and General Practitioner, The Centre Clinic and Melbourne Sexual Health Centre, VIC; Teresa Simpson, Senior Clinician, Psycho-Oncology Social Work Service, Cancer Therapy Centre, Liverpool Hospital, NSW; Mel Tume, Consumer; Prof Jane Ussher, Professor of Women’s Health Psychology and Chief Investigator, Out with Cancer Study, Western Sydney University, NSW; Syr Lumi Vor, Community Member; John Wenborn, Shine a Light (LGBTQIA+ Cancer Support Group).

We also thank the health professionals, consumers and editorial teams who worked on the first the edition of this title. We particularly acknowledge ACON and Intersex Human Rights Australia for their extensive input on the first edition. Intersex-Inclusive Progress Pride Flag designed by Valentino Vecchietti (2021).

View our editorial policy.

What’s on this page

Many LGBTIQA+ people hope to start a family. The path to becoming a parent is different for everyone. Having biological children is one way of starting a family, and this is possible for some LGBTIQA+ people. But this can be made difficult if cancer treatments affect your fertility.

Before starting treatment, it’s important to discuss how cancer treatments may affect your ability to conceive a child or maintain a pregnancy (fertility) and your options for fertility preservation. You can still consider your fertility after treatment, but there may be fewer options.

If having children might be important to you in the future, discuss fertility with your cancer care team before treatment starts. This gives you time to understand and consider your options.

How cancer treatments affect fertility

Cancer and its treatment may affect your fertility. This will depend on the type of cancer, whether you’ve had surgery, chemotherapy or radiation therapy, and your age.

Infertility caused by cancer treatment can be temporary. You may have difficulty conceiving during treatment or for months or years after treatment. Sometimes, infertility is permanent. Some treatments can also cause early menopause. You’ll be advised to avoid conceiving during cancer treatment and for a period of time after treatment, because some treatments can harm an unborn baby.

Ways to preserve fertility

There are different ways to preserve fertility before and after treatment. Keep in mind that these methods don’t work all of the time. For more information about options before and after treatment, see Fertility and cancer.

Options before treatment

Ask your cancer care team about the cost of having fertility preservation and storing eggs, embryos or sperm. Options include:

freezing eggs or embryos
freezing ovarian tissue
surgically moving one or both ovaries out of the field of radiation to preserve their function (oophoropexy)
preserving the uterus, fallopian tubes and ovaries during surgery
for early cervical cancer, surgically removing part or most of the cervix, the upper part of the vagina and nearby lymph nodes, but leaving the uterus, fallopian tubes and ovaries and most of the vagina in place (trachelectomy)
suppressing the ovaries with a long-acting hormone called GnRH analogue treatment before chemotherapy to cause a temporary menopause and protect eggs
freezing or banking sperm
using testicular sperm extraction (TESE)
shielding the testicles during radiation therapy to protect them.

Options after treatment

Your options will depend on how cancer treatment has affected your fertility. Ways to become a parent after treatment include:

using donor eggs from your partner, another known donor or an overseas donor (on an altruistic, non-commercial basis)
using donor sperm from your partner, another known donor or overseas donor (on an altruistic, non-commercial basis)
asking someone (a surrogate) to carry your embryo if you do not have a uterus or it is medically unsafe for you to carry a pregnancy. Only altruistic surrogacy (where the surrogate’s expenses are covered but no other payment is made) is legal in Australia. Commercial surrogacy is illegal
adopting a child
fostering a child for emergency, respite, short- or long-term care (in Australia, there are more opportunities to foster than to adopt).

Checking fertility after treatment

After treatment, you may want to do some tests to see how your fertility has been affected. These may include blood tests, sperm count or ultrasound. Some tests, such as vaginal ultrasound, may be challenging for some LGBTIQA+ people. The results will help your doctors recommend the best options for having a child after cancer treatment.

Pregnancy after cancer treatment

You might be advised to wait up to 2 years after treatment ends before trying to get pregnant. There are many ways to approach conceiving a child, either on your own or with a partner.

Options if you or your partner can become pregnant

Your partner could have their eggs fertilised with donor sperm through IVF and then carry the pregnancy.
If your eggs were collected before treatment or are undamaged after treatment but you’ve had your uterus removed, you could consider reciprocal IVF. This means you go through the IVF cycle and once the embryos mature, they are transferred to your partner to carry the pregnancy. This is legal in most Australian states and territories. In Western Australia, reciprocal IVF is currently only available for medical infertility, but laws are changing.
• If your eggs have been damaged, but you have your uterus and your partner has ovaries, your partner’s eggs could be fertilised with donor sperm and then you carry the pregnancy.
If neither of you can provide eggs, you could use donated eggs.

Options if you and your partner produce sperm

You will need an egg donor and a surrogate to start a family. If your sperm has been damaged, your partner may be able to provide sperm. If neither of you can provide sperm, you could use donated sperm

Options if you are single

You may be able to use donated eggs or sperm, including from overseas. Laws about donor eggs and sperm vary between countries, and there may be restrictions on exporting or importing them into Australia, so it’s important to get legal and medical advice.

Emotional impact of infertility

People respond to infertility in different ways. Common reactions include: shock at how cancer or its treatment has affected fertility; grief for future plans; and anger or depression about changes to life plans and loss of control. People who didn’t get a chance to think about their fertility until after treatment often say the emotions are especially strong.

It may help to consider other ways of becoming a parent, such as adoption or fostering, or you may decide to stop trying to have a child.

Infertility and relationships

Cancer and infertility can cause tension within a relationship. How your relationship is affected may depend on how long you have been together, expectations about becoming parents, the strength of your relationship before cancer and infertility, and how well you communicate.

Changes to your fertility may mean renegotiating who will provide eggs or sperm or who will carry the pregnancy. If your partner is unwilling or unable to be the biological parent, you might feel like you’ve missed the opportunity to have a family. Seeing a fertility counsellor can help.

If you’re starting a new relationship, you may want to share your cancer diagnosis and its impact on fertility when you can trust the person.

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