Can I have sex?
At some times during your treatment you may be advised by your doctor that it is not safe for you to have sexual intercourse. This is because you are more prone to bleeding. If you are having sex it is sensible to use a condom and water-based lubricant to minimise the risk of excessive bleeding and, as always, infection. Using a condom is also important to protect your partner from chemotherapy drugs that can be excreted in body fluids in the first few days after they are administered.

Your treatment team may want you to reach a certain blood count before they think it is safe to resume sexual activity. Again, advice will vary from person to person.
No one should try to conceive during treatment for blood cancers because the anti-cancer drugs used in your treatment are toxic and damage the DNA which makes up your genes. Therefore there is a real risk of causing harm to the baby. For the same reason men should not try to become fathers during treatment because the drugs can damage sperm and increase the chance of abnormalities in the baby. Birth control should be used until your specialist has advised that it is safe to try to get pregnant.

One of the consequences of fatigue and/or anaemia is a lack of sex drive in males - some of whom may have difficulty in achieving an erection. Although this can be a rather embarrassing topic to discuss either with your partner or health-care workers there is plenty of advice available that will help you in your unique situation. Women can also lose their sex drive during cancer treatment. Again there is lots of information and advice available from specialists, books and the Internet.

Will I be able to have children after treatment when I decide to?
As a young person, becoming a mother or a father may have been the last thing on your mind even before you were diagnosed but you need to know that some chemotherapy and radiotherapy regimes can compromise fertility in both men and women. If you haven’t had total body irradiation the chances are that your fertility may not be affected in the long run but ask your specialist about the impact of your treatment on fertility and any options that are open to you.

Unfortunately, nearly all people who have total body irradiation prior to a stem cell transplant lose their fertility. There is no way to preserve fertility in these cases but when the decision to transplant is made, it is because it gives the best chance of cure for the patient.

Radiation therapy may also contribute to reproductive problems. In some women it can cause ovarian failure and lead to early menopause.  This requires treatment with hormone therapies until the ‘normal’ menopausal age.

Can anything be done?
Men can have their sperm frozen to be used at a later stage as part of IVF. This option should be offered to all males at diagnosis.  Make sure that you discuss this with your consultant or nurse. For women the options are fewer and less routinely practiced, usually because they take much longer than sperm collection and will delay starting treatment. For women who have a steady partner or husband, it is possible to harvest the eggs and fertilise them with the partner’s sperm. The resulting embryos can then be frozen and stored for use as part of IVF in the future. Simply freezing a woman’s eggs is ineffective. Freezing of ovarian tissue may be available to some women as part of a clinical trial but this is far from routine practice.

Sometimes there is just not enough time to consider procedures to preserve fertility because rapid treatment is the priority.

Does my treatment affect the chances of me having a healthy child?
People who have had chemotherapy and radiotherapy often voice concerns about the impact of their treatment on the health of their future children. You can be reassured that studies of children born to parents who received cancer treatment show no excess of abnormalities or of childhood cancer in their offspring.

To further understand your fertility options as a cancer patient, please take a look at the useful information provided by the Flinders Reproductive Medicine centre or visit fertileHOPE online.

You can also view a podcast on Dating & Sexuality which is an open and honest discussion by cancer patients and survivors about this important issue (produced by LiveStrong Young Adult Alliance)