Some of the chemotherapy drugs used to treat chronic myeloid leukaemia can cause temporary or permanent infertility. Your doctor or nurse will talk to you about this in more detail before you start your treatment. If you have a partner you may want them to join you at this time so you can discuss any fears or worries together.

It is important to remember that some drugs have less effect on fertility than others. There are many couples who have had normal, healthy babies after one of them has been treated for leukaemia and there is no greater risk of the baby having a mental or physical abnormality than in the general population.

Unfortunately, people who have had intensive chemotherapy and radiotherapy as part of high-dose treatment and stem cell support are likely to be permanently infertile.

As your doctor knows the exact type of treatment you are having, they are the best person to answer your questions. Make a list of any questions that you have so you are clear about your treatment, and the effect it is likely to have on you, before it starts.

It is usually possible for men to have some of their sperm stored before they start treatment so that it can be used later if they want to have a family.

Most women find that their periods stop or become irregular during treatment. Periods may go back to normal once the treatment is over, but sometimes they will stop completely. Women who are having periods can take hormone tablets before their chemotherapy starts, to stop them having the effects of an early menopause, such as:

• hot flushes
• dry skin
• dryness of the vagina.

However, the hormones will not prevent infertility.

Contraception

It is important for women of childbearing age to continue to use reliable contraception during treatment because pregnancy is not advisable at this time and it is not certain whether chemotherapy will always cause infertility.

Sometimes a woman’s fertilised embryos can be stored before chemotherapy so that they can be put back into the womb after treatment to enable the woman to have a child. It is also possible to store unfertilised eggs, although this is less successful and still being researched as a way of preserving fertility. Both of these procedures are difficult and can take some time – possibly weeks or months.

Some treatments for CML can stop you being able to have children. If this is a problem for you, talk to your doctor, who may be able to suggest ways of dealing with this.

If your treatment has made you infertile, it can be very difficult to come to terms with the fact that you can no longer have children. You may feel that you have lost part of your identity.

The leukaemia and its treatment may make you lose your interest in sex for some time. The effects of treatment for leukaemia, such as hair loss and having a central line or PICC line, may make some people feel self conscious and less attractive.

Our section on sexuality and cancer looks at the effects cancer and its treatment can have on sexuality and fertility. It also suggests ways to keep love and sex alive during this difficult time.

Talking about your feelings with your partner, family or a close friend can help to clarify your thoughts and give the people close to you the chance to understand how you are feeling.

If it would be easier to talk to someone outside your immediate friends and family, you may find it helpful to talk to your doctor, nurse, social worker or a trained counsellor.

Our cancer information and support service nurses can discuss these issues with you and can give information on how to contact a counsellor in your area.