Most, but not all, patients who undergo a blood stem cell transplant will become infertile. If you had a reduced intensity transplant (nonmyeloablative transplant) you are less likely to become infertile.
Fortunately, there are options available to couples that wish to have children after a transplant.
Men: Artificial Insemination/Sperm Retrieval
If you banked sperm prior to transplant, it may be used afterward to conceive a child. Although artificial insemination is not always successful, many men have had children after transplant by this method.
If you did not bank your sperm prior to transplant, a procedure called testicular sperm extraction may be an option. Even if you currently have no sperm in your ejaculate, there may still be sperm in your testicular tissue that can be used to fertilize a woman's egg in the laboratory. The resulting embryo is then implanted in a woman's uterus in a procedure called in-vitro fertilization.
Women: In-Vitro Fertilization
In-vitro fertilization is a process which implants fertilized eggs into a woman's uterus. If you created and stored embryos prior to your transplant, they can be implanted into your uterus after transplant.
If you do not have any stored embryos, you may be able to use eggs donated to you by a donor. The donor eggs are fertilized with your partner's sperm and implanted into your uterus. While not always successful, many transplant survivors have successfully used in-vitro fertilization to have children after transplant.
The Society for Assisted Reproductive Technology offers data on success rates at fertility clinics, as well as patient fact sheets that may be helpful as you consider your options for having children after transplant.
Another possible path to building a family is adoption. If you are considering adoption, you will need a home study to certify that you will be a good parent, which includes a medical evaluation.
You may need a letter from your oncologist or hematologist emphasizing that you:
- have a normal life expectancy
- are physically able to care for a child
Although adoption can take time and persistence, but many transplant survivors have successfully built a family through adoption.
A Note of Caution
Although most people will be infertile after transplant, there have been a number of cases where children have been conceived without any sort of medical intervention after transplant.
If you don't want to have children after transplant, using protection when having sex is recommended.