Below you will find a number of questions patients have asked us. Click on the question to see the answer.What is oncofertility? What is infertility? What is the difference between IVF and IVM? Does cancer treatment always affect one's fertility? Does every type of chemotherapy or radiotherapy have the same impact? Will I be able to have children after my cancer treatment (as a woman)? Can I still hope to have a child of my own after cancer treatment (as a man)? Will cancer treatment make my sperm useless for the purpose of procreation? How long do I have to wait after cancer treatment before I can try to get pregnant? Will a pregnancy increase my chances of a 'relapse'? Can a past cancer treatment affect my pregnancy or the development of the foetus? How soon after cancer treatment can my fertility be checked? I do not have a partner. What are my options? How much does oncofertility treatment cost? What if I get cancer while I am pregnant? What is oncofertility? Oncofertility is the medical discipline at the crossroads between cancer treatment and fertility medicine. It aims to preserve the fertility of cancer patients who are at risk of becoming infertile due to chemotherapy or radiotherapy treatment.Top What is infertility? Being infertile or sterile means that you are no longer able to reproduce.There is a difference with sub-fertility. In case of sub-fertility you have a reduced fertility level: you may still get pregnant by means of fertility treatment.TopWhat is the difference between IVF and IVM? In case of IVF or in vitro fertilisation mature egg cells are picked up from the ovaries after hormonal stimulation during an average ten to twelve day period. These are then fertilized with sperm cells at the lab. If everything goes well complete embryos develop after a few days, which can then be frozen.IVM stands for in vitro maturation of egg cells. This technique involves picking up immature egg cells from the ovaries or from ovarian tissue, which are then matured at the lab. The procedure only requires a short or no hormonal stimulation prior to its performance. After the maturation process mature egg cells can be fertilized, and then the resulting embryos can be frozen.IVM is a treatment that can be completed in just a couple of days, which is a big advantage for patients whose cancer treatment must be started up urgently.Both the above techniques can also be combined with egg cell vitrification. In that case the mature egg cells are not fertilized at the lab, but frozen straight away.Top Does cancer treatment always affect one's fertility? Unfortunately, the answer is almost always yes. Especially in case of chemotherapy – which is aimed at affecting the quickly dividing (cancer) cells – the reproductive cells are often affected.Sperm cells originate from stem cells following continuous and complicated division, a process that is arrested by chemotherapy. The result: the sperm cell production is shut down.Egg cells mature in the course of the menstrual cycle, a process which stops under the influence of chemotherapy. The result is that your cycle will stop and you will have no more menstrual periods.During cancer treatment you are de facto infertile. Whether this is a temporary situation depends on different factors and is difficult to predict.Unfortunately, the primordial follicles in prepubertal girls and the spermatogonial stem cells in prepubertal boys are vulnerable to cancer therapy. This means that the fertility of young children is also threatened by cancer treatment.TopDoes every type of chemotherapy or radiotherapy have the same impact? It is possible to anticipate whether you have a low, average or high risk with a certain cancer treatment. When assessing this risk account is taken of the type of cancer and the prescribed chemotherapy or radiotherapy, but also your age and the egg cell reserve (of women).However, this is just an estimate: your individual risk is difficult to predict.Moreover, the initial chemotherapy or radiotherapy may have to be intensified if the initial treatment does not have the desired effect. If your cancer treatment has already started, the options to preserve your fertility are rather limited.TopWill I be able to have children after my cancer treatment (as a woman)? The chance that your fertility will spontaneously recover after a cancer treatment depends on a variety of factors: the duration of the treatment, the administered doses and types and combination of chemotherapeutic drugs, the doses and location of the radiation therapy, ... (see What is gonadal toxicity?)Your age at the time of the cancer treatment is also important. The further you are advanced in your 'reproductive age', the higher the chance of permanent infertility. A girl or a young woman have the best chances of getting pregnant naturally after cancer therapy. A woman aged thirty will usually have a temporary period of amenorrhoea (the absence of menstrual period), a woman aged forty will often become permanently infertile.The reversibility of infertility caused by cancer treatment is very difficult to predict. The recovery may take several years, and then your periods may suddenly resume. Equally, the fact that your menstrual cycle is normal again does not imply that your fertility has also come back to normal.In practice we often find that there is reduced fertility anyway and that medical assistance is often recommended to see your wish to have children fulfilled.TopCan I still hope to have a child of my own after cancer treatment (as a man)? The toxic effect of chemotherapy (see What is gonadal toxicity?) on the reserve of stem cells and therefore also the sperm cell production depends on different factors: which (combination of) products was used, which doses were administered, how long were they administer, were you irradiated in the groin area, how old were you when you underwent cancer treatment, ...Because of this it is difficult to predict whether infertility caused by your cancer treatment is reversible or not. It differs from person to person, in terms of individual susceptibility to the medication, in terms of underlying malignity of the cancer, ...Unfortunately it is often the case that sperm cell production remains limited if it persists or resumes, resulting in a strongly reduced fertility score.TopWill cancer treatment make my sperm useless for the purpose of procreation? In other words, does chemotherapy result in genetic defects of the stem cells, which causes the sperm cells to be genetically damaged even when the sperm cell production returns back to normal? Theoretically the risk certainly exists. Laboratory tests in animals show an increased risk of miscarriages and congenital birth defects.But, fortunately, such an increased risk has not yet be demonstrated in humans. Therefore, there is no need to consider terminating a pregnancy if conception takes place after cancer treatment. Rigourous monitoring of the pregnancy is recommended, though, possibly in combination with a prenatal test, although the latter may be based on psychological considerations.During chemotherapy you should use a birth control method, just to be safe, until at least three months after stye end of treatment.TopHow long do I have to wait after cancer treatment before I can try to get pregnant? When your cancer treatment is successfully completed, you should really take your time to recover completely. Some time will pass before you can carry on with your life and go back to your daily activities.Medically speaking you can try to get pregnant as soon as your oncologist or haematologist considers it safe. On average that would be two years after cancer treatment.TopWill a pregnancy increase my chances of a 'relapse'? In general the information about the safety of a pregnancy after surviving cancer is quite reassuring. A pregnancy does not seem to increase the chances of a relapse of cancer, not even in women with hormone-sensitive breast cancer.However, more research is required. Pregnant cured cancer patients always have to be carefully monitored by a doctor who also keeps an eye their general health.TopCan a past cancer treatment affect my pregnancy or the development of the foetus? In other words, can chemotherapy cause genetic defects to the egg cells, thus increasing the chances of abnormalities of the foetus? Theoretically this risk exists, but fortunately it has not been demonstrated in humans. To date no higher incidence of abnormalities of the embryo has been found in women who have undergone cancer treatment compared to other women. Therefore, there is no need to consider terminating a pregnancy that occurs after a course of chemotherapy.It is, however, recommended to monitor the pregnancy carefully, because the growth of the foetus may be compromised. And based on psychological considerations an amniocentesis is sometimes recommended in the fourth month of pregnancy. Women whose womb was irradiated have an increased chance of giving birth prematurely.TopHow soon after cancer treatment can my fertility be checked? As of six months after cancer treatment you can make an appointment with CRG to have your fertility checked. For men the assessment will be done based on a sperm sample, for women a blood test and an ultrasound scan of the ovaries will be performed.TopI do not have a partner. What are my options? Since a couple of years science has advanced to the extent that not only embryos can be cryopreserved efficiently, but also egg cells. In addition, cryopreservation is also possible for ovarian tissue.This is important for female cancer patients who do not (yet) have a partner: thanks to these techniques they have a chance of having children later by means of fertility treatment. Pregnancy figures of CRG at UZ Brussel demonstrate that the chance of a successful treatment is almost the same for thawed egg cells and for thawed embryos, compared to their fresh counterparts.For a man it does not make a difference whether or not there is a partner involved. The method to preserve your fertility is always by cryopreservation of sperm samples.TopHow much does oncofertility treatment cost? Different treatments are possible to preserve your fertility. The different techniques can also be combined to increase your chances of success.Unfortunately not all treatments are reimbursed by the national health insurance. For cancer patients CRG charges a reduced fee.For more information: contact the oncofertility coordinator.TopWhat if I get cancer while I am pregnant? You may be diagnosed with cancer while you are pregnant. It may not always be necessary to terminate your pregnancy. Cancer treatment may be possible during pregnancy: for most types of cancer, cancer treatment does not differ whether or not your are pregnant. The chances of recovery and survival are also similar.With regard to the risks involved for the baby, if chemotherapy is started after the phase of foetal development , i.e. when the formation of the organs is finished, the placenta will protect the foetus against the toxic effects of the chemotherapeutic drugs.Follow-up in children has been performed for extended periods of time, even though a lot of research is still ongoing worldwide. The initial results seem to indicate that children whose mothers received cancer treatment during the pregnancy are not worse off than other children.Top