Women survive, retain fertility better than men after childhood cancer treatment

Chemotherapy and radiation frequently cause infertility or premature menopause.

A study has revealed that women who underwent chemotherapy treatment in childhood are more likely to retain their fertility than their male counterparts later in life.

The discovery was made by research scientists investigating the long-term effects of cancer treatment drugs on the future fertility of both men and women who survived childhood cancer.

In a report published in The Lancet Oncology journal, Dr Eric Chow of the Fred Hutchinson Cancer Research Center in Seattle, USA, tracked individuals diagnosed with the most common types of childhood cancer before the age of 21 and treated across institutions in the United States and Canada between 2000 and 2024. The participants had survived at least seven years after diagnosis and were followed up to the age of 27.

The team, led by Dr Chow, found that by the age of 45, around 70 per cent of female cancer survivors had become pregnant, compared to 50 per cent of male survivors who had fathered children. Among men, the likelihood of fathering a child declined significantly with exposure to chemotherapy drugs known as alkylating agents.

The findings are consistent with previous studies showing that men treated with these drugs often experience reduced sperm counts and decreased testicular volume, thereby lowering their chances of fathering children. Meanwhile, related studies by the same research group on female cancer survivors indicated that although treatments such as chemotherapy and radiation frequently cause infertility or premature menopause, fertility preservation methods, including egg or embryo freezing and ovarian tissue cryopreservation, were successful in preserving reproductive potential in 41 to 53 per cent of cases.

A 24-year follow-up showed roughly one in six women who stored reproductive cells achieved successful pregnancies, with higher success in breast cancer patients. “Chemotherapy and radiotherapy significantly impact ovarian function, while high-dose pelvic radiation increases miscarriage and preterm birth risk,” Dr Chow said.

In men, treatments including chemotherapy, radiation and surgery often cause temporary or permanent infertility, affecting 15–30 per cent of survivors.  Pre-treatment sperm banking is the standard preservation method.

Experts urge regular cancer screening, noting early detection enables timely intervention and more effective management.