As in men, radiation therapy and chemotherapy can change a woman’s ability to produce children. However, the process in which the damage to reproductive system occurs is quite different between males and females.
Interestingly, egg cell production in women begins in the ovaries before she is even born. The cells develop before birth to a stage of maturity called the oocyte stage, where they wait until the girl reaches puberty. Most of the million or so oocytes that she has at birth will never fully develop into mature egg cells.
When a young lady begins her menstrual cycles, the tissues of the ovary will communicate with the oocytes and produce the hormone estrogen. Estrogen will encourage the oocyte to mature and be released by the ovary (ovulation) where it can either pass on or be fertilized by a sperm cell to make a baby.
Treatment for such cancers as leukemia or lymphoma can cause damage to the oocytes and tissues that surround them. This may lead to an inability to ovulate, a decrease in the amount of estrogen and early menopause (stopping of menstrual periods). These changes are called ovarian failure.
As women age, the number of oocytes that are available to develop into fully mature egg cells decrease. Because cells that help support and give rise to oocytes are most vulnerable to age, women in their late 30s and 40s are more likely to experience ovarian failure as a result of their cancer treatment.
In some cases, a woman’s menstrual cycle may return following completion of chemotherapy or radiation therapy. In these cases, it is possible that she will go through menopause earlier than she would have otherwise, shortening the period in which she can produce babies.
While it is quite common for treatment of blood cancers to affect fertility in females, there may be some steps your healthcare team can take to help preserve your ability to produce children in the future. Some of these options are more effective if carried out before treatment begins, so it is important to discuss your possibilities early in your diagnosis- even if it is the furthest thing from your mind.
Krebs, L. “Sexual and Reproductive Dysfunction” in Yarbro, C., Frogge, M., Goodman, M., and Groenwald, S. eds. (2000) Cancer Nursing: Principles and Practice 5th ed.Jones and Bartlett: Sudbury MA. (pp.831- 854).
Lee, S., Schover, L. Partridge, A. et al. American Society of Clinical Oncology Recommendations on Fertility Preservation in Cancer Patients. Journal of Clinical Oncology 2006;24(18):2917- 2931.