Sex, fertility and acute lymphoblastic leukaemia (ALL)
Having acute lymphoblastic leukaemia (ALL) and its treatment might affect your sex life and 
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Your sex life and ALL
Your sex life and ALL
ALL can impact your relationships and sex life, but not always. The symptoms and treatment of ALL can lead to physical changes in your body and alter how you feel about yourself.
Feeling anxious and stressed is common, and mood can affect your interest in having sex. You may have times when you don’t feel like having sex because you are too tired, or you have other side effects of treatment.
Speaking openly with your partner and sharing your concerns or worries can help. Talk to your doctor or healthcare team for more advice.
Contraception and protecting your partner during sex
Always use reliable contraception when you are having treatment for ALL. You should not become pregnant or father a child while having chemotherapy or other cancer treatments. This is because some treatments can harm the baby and increase the risk of miscarriage. You may need to continue using contraception for a little while after your treatment has finished. Your doctor will discuss this with you.
It is not known for sure whether cancer drugs, such as chemotherapy, can be passed on through semen or secretions from the vagina. Because of this your doctor might advise you to use a barrier contraception, such as condoms. This is usually only while you are having treatment. You should use the barrier method when having vaginal, anal or oral sex.
Fertility after ALL treatment
Treatment for leukaemia can make it harder for you to get pregnant or father a child in the future. But there are many people who have leukaemia treatment that do keep their fertility. Before treatment, your doctor will talk to you about your risk of infertility. They can also refer you to a fertility specialist who can give you more information and support.
At the end of treatment, you usually have checks to see how treatment has affected your fertility. They check:
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the quality and number of sperm if you are male
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your hormone levels
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your ovaries, womb (uterus) and fallopian tubes if you are female – you have an ultrasound scan to check this
You are at a higher risk of permanent infertility if you have had a . This is because you may have high dose chemotherapy and total body irradiation before a stem cell transplant.
If you have a partner, you may want to see your doctor together so that you can both discuss any fears or worries. Don’t be afraid to ask questions. Being well informed can help you cope.
Men and infertility
Treatment might affect a man’s fertility by:
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reducing the number of sperm you make, or stopping you making any at all
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affecting the ability of the sperm to fertilise an egg
This might be temporary or might mean you can no longer get someone pregnant.
Women, infertility and early menopause
Chemotherapy and radiotherapy are treatments you might have for acute leukaemia that can affect your fertility. These treatments can stop from making eggs. If this happens, you won’t be able to become pregnant. It can also cause you to have an early menopause.
The menopause is normally the period of time between the early 40s and late 50s. This is when women stop producing sex causing their periods to become irregular and eventually stop. Women can then no longer become pregnant. If you go through menopause before the age of 40, your doctor may call this premature ovarian insufficiency, or POI.
Some of these symptoms of menopause include:
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hot flushes and sweating
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missing periods or periods stopping completely
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vaginal dryness
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feeling sad or depressed
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loss of confidence and self esteem
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joint pains and muscle aches and you may have thinning and weakening of the bones (osteoporosis) over time
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loss of interest in sex (libido)
Talk to your doctor or nurse if you have any of these symptoms. There are treatments and things you can do to help cope with the effects of menopause. Your doctor might recommend you have
Preserving fertility
There are ways for both women and men to try to preserve their fertility, such as freezing eggs and embryos, or storing sperm. However, these methods are not always successful or suitable for everyone.
If you have acute leukaemia, you often need to start treatment right away. For women, freezing eggs can take several weeks because you need to take medications to help your ovaries make eggs. After that, a doctor collects and stores the eggs. Because this takes time, many women can’t freeze their eggs before treatment begins. You may be able to have ovarian tissue freezing (cryopreservation), but this is not suitable for everyone and is not available everywhere.
For men, it may be possible to collect and store sperm. This is called sperm banking. Whether this is an option depends on how well you feel and how quickly treatment needs to start.
Talk to your doctor or nurse about any concerns you may have about your fertility.
Contraception
It is still important to use contraception during treatment and for some time after. Your doctor, nurse or pharmacist can tell you how long this should be. Becoming pregnant or fathering a child during and shortly after treatment may affect the developing baby.
If you don’t want to have a baby, you should continue to use contraception after treatment until you know for certain if you are infertile or not.
Coping with infertility
It can be extremely distressing to find out that your leukaemia treatment could stop you from having children. It can seem very unfair to have to cope with this as well as your diagnosis. Even if you hadn’t thought about having children before, losing your fertility can be very difficult to cope with. It can also affect how you feel about yourself.
It takes time to adjust. You need to give yourself time to feel sad and come to terms with it. You might accept the news to begin with, but find difficult to cope with when the treatment is over.
It can help to know that you're not alone. Many people feel like you at some time during their treatment. It can be helpful to share experiences.
Talking to other people
Talking to someone close to you is usually helpful, although you might not be able to do this for a while. Help your family and friends by letting them know if you would like to talk about what’s happening and how you feel.
You might want to talk to someone other than your partner, friends or family members. You might find it helps to speak to a counsellor or a therapist. Your doctor or nurse can put you in touch with professional help if you would like it. Don’t be afraid to ask, as it really can help.
That Cancer Conversation
That Cancer Conversation is Cancer Research UK's podcast. In the episode exploring infertility and cancer, we chat with people whose cancer journey has had an impact on their fertility.
It also features Professor Richard Anderson, Deputy Director of the University of Edinburgh’s Centre for Reproductive Health. We explore options that are available and what the future of fertility medicine could look like.
