Fertility preservation

What is fertility preservation?

Fertility preservation allows you to safely store eggs, sperm, embryos or reproductive tissue, such as ovarian or testicular tissue, for possible use in the future. 

It may be recommended before medical treatments that could affect fertility, including chemotherapy or radiotherapy, or for people who wish to delay having biological children until later in life. 

Our fertility specialists at the Assisted Conception Unit, part of Guy’s Hospital, are experts in fertility preservation treatment. Before treatment, we will discuss the likelihood of future pregnancy based on your age, fertility assessment and outcome data of our other patients, helping you make an informed decision about your care.

Why is fertility preservation used?

Medical diagnosis, age and lifestyle choices are all factors that can influence your decision to consider fertility preservation. 

Whether you’re not ready to consider children now but would like the option later in life, or you’re looking to undergo gender-affirming treatments that will alter your reproductive abilities, freezing and storage give you choice with your fertility. 

When it comes to your health, there are a number of treatments that can impact your fertility, such as: 

• chemotherapy 
• radiotherapy 
• hormone therapies 
• surgeries to reproductive organs 

Fertility preservation can increase the possibility of having a biological child in the future, but it cannot guarantee a future pregnancy or live birth. Success depends on many factors, including age at the time of storage, the number and quality of eggs, sperm or embryos stored, the type of fertility preservation used, and future reproductive health.

How cancer treatment can affect fertility

Cancer treatment can affect fertility in different ways, depending on the type of treatment, dosage and duration, as well as your age at the time of treatment. 

Chemotherapy and fertility

Some chemotherapy drugs, including alkylating agents and cisplatin, can damage eggs or sperm and may cause temporary or permanent infertility. While younger people may have a lower risk, age alone does not fully protect fertility from the effects of chemotherapy. 

Radiotherapy and fertility

Radiotherapy can have a significant impact on fertility, particularly when treatment is directed at or near the reproductive organs or areas that control hormone production. The level of risk depends on the dose and location of the radiation. 

Other cancer treatments

The long term effects of newer cancer treatments, such as immunotherapy, are still being studied, and their impact on fertility is not yet fully understood. 

Cancer surgery

Some surgical treatments involve the removal of reproductive organs, such as the ovaries, uterus or testicles, which can result in infertility. 

Time, age and treatment delays

Even when cancer treatment is successful, you may be advised to delay pregnancy for several years. As fertility naturally declines with age, this delay can reduce the chance of conceiving, even without the effects of chemotherapy or radiotherapy. 

You can find out more about our private cancer treatment services here. 

If you’ve been referred for cancer treatment that could affect your fertility, complete the form on this page to speak with our fertility specialists about fertility preservation options before treatment begins. 

Fertility preservation and age 

Female fertility declines naturally with age, particularly after the age of 35. Egg freezing may be considered by women who are not yet ready to start a family but wish to preserve the possibility of using younger eggs in the future. The chance of success is influenced by the age at which eggs are frozen and the total number of eggs stored. 

What to expect during fertility preservation 

Before cancer treatment we provide a full assessment of your fertility potential, and we can then advise on reproductive function after cancer treatment. 

Based on your individual circumstances, we will determine the most suitable fertility preservation option for you. 

Types of fertility preservation 

There are 2 main types of fertility preservation: 

• freezing of eggs, sperm, embryos and ovarian/testicular tissue for future use 
• the minimisation of cancer treatment’s effect on reproductive tissues 

Female fertility preservation 

Our fertility specialists offer various types and methods of female fertility preservation. 

• Egg freezing – harvesting and freezing your unfertilised eggs. 
• Embryo freezing – involves harvesting and fertilising eggs with the sperm of your partner/donor sperm, before freezing them to be implanted in the future. 
• Ovarian tissue freezing/ovarian tissue cryopreservation (OTC) – involves removing a part of or a whole ovary and storing it while you undergo treatment, before transplanting it in the future. OTC is an established fertility preservation technique that can be offered when cancer treatment cannot be delayed, or when hormonal stimulation is not appropriate. Following transplantation, ovarian function often resumes and natural conception may be possible. 

Male fertility preservation 

We offer a range of fertility preservation options for men and boys who may be at risk of impaired fertility due to cancer treatment, medical conditions, or other therapies that can affect reproductive function. 

• Sperm freezing (sperm cryopreservation) – the most established method of male fertility preservation. Sperm can be collected and frozen before treatment and stored for future use in fertility treatment.  
• Surgical sperm retrieval and sperm freezing – for individuals who are unable to produce an ejaculate or who have no sperm present in the ejaculate, sperm may be retrieved directly from the testes using specialised surgical techniques and frozen for future use.  
• OncoTESE (oncological testicular sperm extraction) – in selected patients diagnosed with cancer who are found to have no sperm in the ejaculate before treatment, we can work closely with urology and oncology teams to retrieve sperm directly from the testicular tissue at the time of cancer surgery. This specialist approach may provide an opportunity for fertility preservation when conventional sperm freezing is not possible.  
• Testicular tissue cryopreservation – an experimental fertility preservation option that may be considered in selected circumstances for pre-pubertal boys who are unable to produce sperm. The tissue is stored with the hope of enabling future fertility restoration as scientific advances develop. This intervention remains experimental. 
• Radiotherapy planning and gonadal protection – for patients undergoing radiotherapy, our team may consider techniques to minimise radiation exposure to the testes where clinically appropriate.  

We work closely with oncology, haematology, urology and other specialist teams to ensure fertility preservation can be arranged quickly, often at short notice, so that cancer treatment is not unnecessarily delayed. 

As part of our service, we provide access to specialist fertility counselling and are happy to advise healthcare professionals who are considering referring patients for fertility preservation. 

Fertility preservation in children and young people 

Fertility preservation may be considered for children and young people facing treatments that could affect future fertility. Available options depend on age, stage of puberty and the urgency of treatment. Our team works closely with paediatric and teenage and young adult (TYA) cancer services to provide specialist advice. 

Storage duration 

UK legislation currently allows eggs, sperm, embryos and reproductive tissue to be stored for up to 55 years, provided the necessary consent requirements are met and storage is renewed every 10 years. 

Methods to minimise the impact of cancer treatment on fertility 

Our fertility specialists are experts in minimising the effects of cancer treatment on fertility, offering several options to patients before they begin chemotherapy or radiotherapy. 

• Ovarian suppression – using hormone injections, we can temporarily suppress the ovaries which may reduce the risk of treatment-related ovarian damage in some women. However, it should not be considered a substitute for established fertility preservation techniques such as egg, embryo or ovarian tissue freezing. 
• Ovarian transposition – involves repositioning the ovaries surgically away from the radiation field, offers more protection during radiation therapy. 
• Radiation shielding – placing small lead shields over the ovaries to reduce radiation exposure. 

After cancer treatment 

Fertility after cancer treatment can be difficult to predict. While some patients recover normal reproductive function, others may experience reduced fertility, premature menopause or azoospermia (absence of sperm in ejaculate). We offer specialist assessment, hormone testing, ultrasound scanning and semen analysis where appropriate. 

Your frozen sperm, eggs or embryos can be used if you wish to try for a baby after your cancer treatment is completed. 

We’ll assess your fertility potential and advise on reproductive function. While regular periods after treatment do not guarantee normal fertility, the absence of periods does not always mean you can’t get pregnant. Advice from our fertility experts on appropriate contraception is important while you are recovering from cancer and its treatment. 

We also provide specialist guidance: 

• about HRT and other aspects of women’s health in cases of early menopause 
• on men’s health in cases of testicular failure or male hypogonadism secondary to radiotherapy treatment 
• for women who developed vaginal graft versus host disease following bone marrow transplantation 

Fertility treatment can be provided where possible and we can advise on alternative options including surrogacy and donor treatments. 

For more information or advice on your most suitable fertility preservation option, please book an appointment with our specialists.