Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO. Last updated: June 2026.
Information on this page is educational and does not replace medical advice. Fertility preservation does not guarantee a future pregnancy, and all decisions should be made together with your oncologist.
A cancer diagnosis is overwhelming, and your treatment must come first. Fertility preservation is simply about protecting a future option, where time allows, so that the choice to have a biological family later remains open. The most important step is to raise the question early — ideally at diagnosis, before treatment starts. In Marathi, preserving fertility before cancer treatment may be described as कर्करोग उपचारापूर्वी प्रजनन क्षमता जतन. The embryology and freezing work is carried out in-house under Senior Clinical Embryologist Aayush Agarwal, Ph.D.
Why does timing matter so much?
Fertility preservation is most effective when it is done before any chemotherapy, radiation, or reproductive surgery begins, because these treatments can start to affect eggs and sperm early. Acting before the first cycle of treatment gives the best chance of collecting healthy reproductive cells.
- Ideally, preserve before treatment starts — this protects eggs or sperm from the effects of the cancer therapy.
- Coordinate with your oncologist first — the safe window depends on your cancer type, stage, and the planned treatment. Your fertility plan must fit within, and never compromise, your cancer care.
- If treatment has already begun — preservation may sometimes still be possible between cycles, but the quantity and quality of eggs or sperm collected may be lower. This needs urgent, individual assessment.
Because of this, an early conversation — even a single consultation — can keep options open. There is no obligation to proceed.
How does cancer treatment affect fertility?
Different cancer treatments affect fertility in different ways, and the degree of impact depends on the treatment type, dose, the area treated, and the person's age.
- Chemotherapy: Many cytotoxic drugs target rapidly dividing cells and cannot distinguish cancer cells from eggs and sperm. They can reduce the store of eggs in the ovaries — sometimes leading to early menopause — or lower sperm production. The risk depends on the specific drugs, the dose, and age.
- Radiation therapy: Radiation directed near the ovaries or testicles can cause lasting damage. Radiation to the brain can also affect the hormones that control fertility.
- Surgery: Operations that remove reproductive organs (such as the uterus, ovaries, or testicles) have a direct and immediate effect on fertility.
Your oncologist can advise on the likely impact of your specific treatment, which helps you and the fertility team decide whether preservation is appropriate.
What are the fertility preservation options for women?
For women, preservation usually involves stimulating the ovaries to produce eggs, which are then collected and frozen — either unfertilised, or fertilised into embryos. Time is often limited, so "random-start" protocols allow ovarian stimulation to begin promptly, at whatever point in the menstrual cycle you happen to be, rather than waiting for the next period.
- Egg freezing (oocyte cryopreservation): Unfertilised eggs are collected and frozen. This keeps options open for women who do not have a partner or who prefer not to create embryos now.
- Embryo freezing: Eggs are fertilised with a partner's (or donor's) sperm to create embryos, which are then frozen. This requires a sperm source at the time of freezing.
- Ovarian transposition: A surgical procedure to move the ovaries away from the area being irradiated, used in selected cases where pelvic radiation is planned.
- Ovarian tissue freezing: In some centres, ovarian tissue is removed and frozen — relevant where there is no time for stimulation, or before puberty. Ask your fertility team whether this option applies to your situation.
Hormone-sensitive cancers: For cancers such as oestrogen-receptor-positive breast cancer, specialised protocols (for example, using letrozole alongside stimulation medication) can keep oestrogen levels lower during the cycle. These protocols are always planned together with your oncologist.
The egg-collection cycle typically takes around 10–14 days from the start of stimulation to retrieval.
What are the fertility preservation options for men?
For men, fertility preservation is usually quick and non-invasive.
- Sperm freezing (sperm banking): Semen samples are produced, assessed, and frozen in the laboratory. This can often be completed in a single visit, and banking more than one sample is advisable where time permits.
- Surgical sperm retrieval: For men who cannot produce a sample — due to illness, stress, or no sperm in the ejaculate — sperm may be retrieved surgically directly from the testicular tissue before treatment begins.
Because sperm banking is fast, it can usually be arranged without any meaningful delay to starting cancer treatment.
Does fertility preservation delay cancer treatment?
In most cases, the delay is small or none. Sperm banking can often be done in a single day. For women, random-start protocols allow stimulation to begin immediately, and the egg-collection cycle generally takes about 10–14 days. The fertility team works directly with your oncologist so that preservation fits safely within your treatment timeline — your cancer care always takes priority, and the plan is built around it, not the other way round.
If your oncologist advises that treatment cannot wait even this long, that guidance is followed. The goal is to preserve fertility only where it is safe to do so.
What does the preservation process involve, step by step?
- Urgent consultation: A prompt appointment with Dr. Shweta Agarwal to review your planned cancer treatment (in coordination with your oncologist) and discuss whether and how preservation can fit your timeline.
- Ovarian stimulation (for women): Around 10–12 days of hormone injections, started promptly using a random-start protocol where needed.
- Collection: Egg retrieval for women (a short procedure under sedation), or sperm sample collection for men.
- Freezing: The eggs, embryos, or sperm are cryopreserved in the in-house laboratory.
- Proceed with cancer treatment: Once preservation is complete, you continue with your oncology care, with your stored material kept safely for the future.
Stored eggs, embryos, and sperm are kept in liquid nitrogen at very low temperature, which halts biological activity. They can be stored for an extended period while you focus on treatment and recovery, subject to applicable ART regulations and consent.
An honest note on outcomes
Fertility preservation keeps a future option open — it does not guarantee a pregnancy or a baby later. The number and quality of eggs, embryos, or sperm collected, your age, and your future health all affect what is possible. Stored material may be used through IVF or related treatment when you are ready, but success cannot be promised. We will give you a realistic, individual picture so you can make an informed decision — without pressure, and in your own time.
Research to date suggests that children conceived from eggs or sperm preserved before cancer treatment do not face a higher rate of birth defects than the general population, and — unless a cancer is hereditary — are not at increased risk of the cancer itself. Where a hereditary cancer gene is a concern, preimplantation genetic testing (PGT) of embryos can be discussed.
What is the cost, and is any support available?
The cost of fertility preservation depends on which method is used (sperm freezing is the least costly; egg or embryo freezing involves a stimulation cycle), and on ongoing annual storage — so it varies by clinical factors. Final cost depends on individual clinical evaluation — see Costs & EMI for current pricing. Recognising the urgency and stress of a cancer diagnosis, the team aims to arrange a prompt consultation.