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When you first heard your healthcare provider say the word “cancer,” all you could think about was ridding your body of it. But now that you’re in remission, you want to move on with your life and start a family. And that’s when you have to face this fact: The treatment that saved your life may have hurt your chances of having children.

Know the obstacles

For some men and women, cancer treatments can make it very difficult or even impossible to conceive naturally. That’s why many oncology providers discuss fertility preservation methods such as freezing sperm or embryos before treatment. However, if you didn’t or couldn’t protect your fertility before treatment, you may still be able to have children.

The effects your cancer treatment may have had on your fertility depend on your age, the type of treatment you received, the dosage and, in the case of radiation, the area targeted. In general, women who were treated for cancer before age 30 have the best chance at getting pregnant after treatment. This may be because a younger woman has more eggs left. Still, chemotherapy and radiation may stop ovulation and cause early menopause. For men, cancer treatments may reduce the number of sperm they produce or the sperms’ ability to swim. A fertility specialist can perform a semen analysis to find out whether the sperm are viable.

Get professional guidance

If you’re a woman who has had chemotherapy or radiation to your pelvic or abdominal area, you need to know whether your uterus is healthy before getting pregnant. This can help you avoid pregnancy complications such as miscarriage or premature birth. Your provider will also check to make sure your heart and lungs, which can be damaged by cancer treatments, are healthy and able to withstand a pregnancy. He or she may recommend that you wait at least six months after treatment before you try to get pregnant to avoid fertilization of a damaged egg, which can lead to miscarriage or genetic problems. Men should also wait six to 12 months after treatment to avoid fertilization by damaged sperm.

Ask yourself the tough questions

What if you knew your cancer would return? Would you still attempt pregnancy? How do you feel about your child possibly losing his or her mother or father to recurring cancer? Are you afraid that you carry cancer genes that could be passed along to your child? Because these can be very difficult questions to answer, some experts recommend you wait before conceiving. For example, if you had breast cancer, your healthcare provider may suggest waiting two years after you stop treatment. This is the period when cancer is most likely to return in a young woman.

Afraid that getting pregnant could cause your cancer to come back? Worried that your prior cancer will somehow affect your baby’s health? Pregnancy-related hormones haven’t been shown to increase the risk of cancer recurrence, nor does the mother’s cancer history seem to affect her baby’s health. Still, it’s a good idea to discuss any concerns you have with your healthcare provider or a reproductive specialist, genetic counselor or mental health professional.

Consider the alternatives

Sometimes having a baby naturally just isn’t possible. If this is the case, talk to a reproductive specialist about methods such as in vitro fertilization, donor sperm or eggs, surrogacy or adoption. It may not be the way you envisioned parenthood, but it still can be a fulfilling option for you.