Fertility and womb cancer

Many women who are diagnosed with womb cancer have finished their family. And many will have been through the menopause. For those who are able to and would like to have children, it will be difficult to cope with a diagnosis of womb cancer. The treatments for womb cancer are likely to affect your ability to have children.

How treatment can affect fertility

Womb cancer mostly affects women who have gone through their menopause. More rarely, it can affect younger women who still want to have children. Most treatments for womb cancer will affect your fertility and mean that you are unable to have children.

The main treatments for womb cancer are surgery and radiotherapy. Some also need cancer drug treatment with chemotherapy or targeted treatments. These can also affect fertility.

Is it possible to have treatment that doesn’t affect my fertility?

Most treatments for womb cancer will affect your ability to have children. Hearing this when you haven’t started a family or haven’t finished will be difficult.

Whether it is possible to have fertility preserving treatment will depend on:

• how big your cancer is and how far it has grown, this is the stage of your cancer
• how abnormal the cancer cells are, this is the grade of your cancer

To have fertility preserving treatment, your cancer needs to be at an early stage. This means it needs to be stage 1A grade 1 womb cancer.

The usual treatment for early stage womb cancer is surgery. This gets rid of the cancer for nearly all those having it. Choosing to have fertility preserving treatment means you aren’t having standard treatment. Your doctor will talk to you about the possible risks of not having surgery straight away.

Anyone wanting to have fertility preserving treatment is usually seen at a specialist centre. First, they will want to confirm the stage of your cancer. This means that you will need to have a sample of tissue taken. This is called a biopsy. You will also need to have an MRI scan.

Fertility preserving treatment means taking the hormone treatment progesterone. This aims to shrink the cancer, and for some, it may go away. Then, after six months of hormone treatment, you have another biopsy of your womb and an MRI scan to check how well it is working.

If treatment hasn’t worked your doctor will recommend you have surgery to remove the cancer. If it is working you have a chance to get pregnant. Your doctor may refer you to a fertility specialist.

Your doctors will want to see you regularly, and you will need tests. This is to monitor the cancer and whether it has grown. 

Once you have had your children, your specialist will recommend that you have surgery to remove your womb.

Coping

Not being able to become pregnant and give birth can be quite a shock. You might need time to:

• come to terms with your loss of fertility
• deal with the feelings that come with a natural change of life as well as a diagnosis of cancer

This can even be true if you have had your menopause and could no longer become pregnant. It can feel like the end of a particular phase of life.

Many women feel a great sense of loss after surgery to remove the womb. Some find the operation makes them feel less feminine. 

Talk to your GP, nurse or hospital doctor if you feel you need some help. A support group might be helpful. Or you could think about counselling.