Fertility tests after cancer treatment

Different cancer treatments can affect fertility in different ways. After your cancer treatment, tests can help find out how your fertility has been affected.

Semen tests

After cancer treatment, you can have your semen tested. This is called semen analysis.

The test checks whether you are producing healthy sperm and the amount you are producing. Your cancer doctor or nurse can explain when you can have this test.

Your cancer doctor or GP can arrange an appointment for you to give a sample for testing. You usually give a sample by masturbation at home or at a clinic. The clinic will give you information about this.

Your sample is then checked in a laboratory under a microscope. Your doctor can tell you what to expect and when your results will be available. A fertility specialist will talk to you about the results of the test.

Semen testing is available free on the NHS. You can also pay to have it privately. If needed, you can have the test again to see whether things have changed.

Ovarian reserve tests

The number of eggs in the ovaries is called your ovarian reserve. After cancer treatment, you may have tests that help your fertility doctor measure your ovarian reserve. These tests can also help show whether the ovaries are releasing eggs and whether you may have started the menopause.

Usually, people are only referred to a fertility clinic after 1 to 2 years of trying to start a pregnancy. If you have had cancer treatment, you should be referred for ovarian reserve testing sooner than this. This is because you have a higher risk of an early menopause after cancer treatment.

You may have:

• blood tests to check your hormone levels – your doctor will explain when these should be done
• an ultrasound scan to look at follicles in the ovaries – this is called an antral follicle count.

Ultrasound uses sound waves to check how the follicles containing the eggs are developing in the ovaries. The ultrasound probe goes inside the vagina. This is not usually painful. The probe is about as wide as a large tampon.

If you take the contraceptive pill, hormone replacement therapy (HRT) or gender-affirming hormones, it can affect the results of some of these tests. Let your doctor know if you are taking any of these. They may ask you to stop taking them before having the tests.

The results do not always clearly show whether you will be able to start a pregnancy. But they may help you decide what to do next. They may help you decide whether you want to find out more about fertility treatment.

Some people only start having periods again months or years after cancer treatment ends. This is more likely if you are younger. But it also depends on the treatment you have had. If your periods change, you can have these tests again. Your doctor will talk to you about the options available to you.