Remember:
This page offers general fertility information and support for people having a stem cell transplant, or people who’ve already had one.
When it comes to fertility and transplant, it’s important to speak to your medical team about your own situation as soon as possible. Your options might depend on certain timings or requirements.
You can use the information on the page as a guide for next steps, but not everything will apply to everyone.
Why might stem cell transplant affect my fertility?
Having a stem cell transplant can affect your fertility for many reasons related to both your physical and mental wellbeing. For example:
- Conditioning therapy, like chemotherapy and radiotherapy
- Early menopause
- Low sex drive
- Genital GvHD
- Low self-confidence and body image
- Changes in relationships
- New perspectives after transplant
You can read more information about each of these reasons below:
Conditioning therapy
Conditioning therapy prepares your body for a stem cell transplant. It’s usually either chemotherapy, radiotherapy, or a combination of both. While it’s necessary for transplant, this treatment can also affect your fertility.
How significantly conditioning therapy might affect your fertility depends on two main factors:
- The type and dose of conditioning therapy. Reduced intensity conditioning therapy might cause temporary fertility issues, or sometimes no issues at all. But high-intensity therapies, like total body irradiation (TBI), might cause permanent infertility.
- Your age. The younger you are, the less chance that conditioning therapy will affect your fertility in the future. We also have an information section on young people and fertility after stem cell transplant.
Your medical team should be able to tell you how conditioning therapy might affect your fertility. If you’ve already had chemotherapy or radiotherapy, hopefully your team explained the potential effects on fertility and alternative options. If not, you can still discuss this with your team now.
Within these two factors, there are further specific reasons why conditioning therapy might affect fertility. This treatment can:
- reduce the number of sperm you produce, or stop production completely
- stop sperm from being able to fertilise an egg
- affect the production of testosterone, a type of sex hormone
- damage or reduce the number of eggs in the ovaries
- affect the way you release eggs from the ovaries
- affect hormone production in your pituitary gland
- affect the cervix, womb or ovaries
- delay puberty in young people.
If you have ovaries, doctors might use the following terms to describe certain effects after conditioning therapy:
- a reduction in ovarian reserve
- ovarian insufficiency
- ovarian failure.
It can feel scary when these terms sound so clinical and negative. It won’t feel helpful for you to hear these reasons if you’re hoping to have children after stem cell transplant. But try to not think the worst if you hear these terms. While it’s important to be realistic about your future, it’s just as important to stay hopeful and empowered. Nobody will experience the same fertility journey post-transplant, even if you get the exact same reasons or labels as someone else. Make sure to explore all options to get the best perspective for your own situation.
Early menopause
Early menopause is a potential effect of conditioning therapy for stem cell transplant. If you experience menopause under the age of 40, you might hear this called ‘premature ovarian insufficiency’ (POI).
As early menopause can also be a late effect of stem cell transplant, it’s important to know the signs. For example:
- hot flushes, which is a sudden feeling of intense heat
- missing periods or periods stopping completely
- vaginal dryness, which can cause discomfort during sex
- not wanting to have sex, which you might hear called ‘low libido’ or ‘low sex drive’
- struggling to sleep
- sweating during the night
- feeling low or anxious
- struggling with concentration or memory.
Lots of us find menopause to be a very challenging time. But experiencing this at a young age might feel especially overwhelming, lonely and unfair. There are different types of treatment and support available to replace certain hormones. Doctors might offer hormone replacement therapy (HRT) or the combined contraceptive pill.
To get information and support about early menopause or POI, visit the Daisy Network.
Low sex drive
Lots of people find they have less interest in sex after a stem cell transplant. Not wanting to have sex as much, or at all, is sometimes called ‘low libido’ or ‘low sex drive’. Your reasons for this could be physical, emotional, or both. Sometimes you might not be able to pinpoint the reason at all.
Low sex drive can be difficult to deal with, whether you’re in a long-term relationship, new relationship, dating or single. But it can also feel very challenging in a different way if you’re hoping to have children soon.
Genital GvHD
Genital graft versus host disease (GvHD) can feel embarrassing to talk about, as well as being physically uncomfortable. You might find it too painful to have sex or any type of contact around your genital area.
Genital GvHD is a common physical side effect of stem cell transplant. Your medical team will be very familiar with this, so try to not feel embarrassed telling them about it. The sooner you get treatment, the sooner you’ll see improvements.
Symptoms of genital GvHD in and around the vagina include:
- vaginal dryness, which means feeling sore or itchy around the vulva and vagina
- inflammation or narrowing of the vagina, which you might hear called ‘stenosis’
- scarring or ulcers in the vagina.
Your medical team might refer you to a gynaecologist. They can treat most of these symptoms by prescribing a steroid cream or gel.
Symptoms of genital GvHD for the penis include:
- a rash on the penis
- ulcers on the penis
- pain or discomfort when peeing
- difficulty keeping an erection.
Your medical team might refer you to a urologist. They can treat most of these symptoms by prescribing a steroid cream.
Some of these symptoms might present differently if you’ve had genital gender-affirming surgery. It’s best to speak to your medical team if you have worries or questions about genital GvHD.
Low self-confidence and body image
Your body might go through lots of changes after your stem cell transplant. During or after your recovery, you might:
- lose your hair
- lose or gain weight
- have dry, red or blotchy skin due to GvHD
- experience genital GvHD.
It’s common to struggle with your confidence and identity after experiencing physical changes. While struggling with body image and self-esteem, you might not feel up to any sort of sexual activity. This is totally fine – you should never feel pressured into sex.
It might feel difficult if struggling with body image is stopping you from having sex when you want to have children. But you have to take care of yourself first and do things at your own pace. In time, you can build your confidence back up. It might also help to read stories from people who’ve gone through this.
Changes in relationships
Having a stem cell transplant can bring you and your loved ones closer, or it might end up pulling you apart. The treatment and recovery period can feel like a very complicated time. You might find your relationships, priorities and responsibilities change a lot.
Going through any of the physical and emotional changes listed on this page can be a difficult process for any relationship. But if you’re experiencing this along with potential fertility problems when you want to start a family, this can feel even harder to cope with. Try to:
- take things one step at a time
- communicate openly and honestly
- go easy on yourselves
- treat each other with kindness and respect.
New perspectives after transplant
Having a stem cell transplant can save your life. It might be your final treatment option after a long journey since your initial diagnosis.
When you’ve been through so much, or you’re going through so much, you might find yourself re-evaluating your life and future. It might make you think about whether or not you want to have children after all.
You might have lots of different thoughts and feelings about this, and they might change at different times in your journey. You might relate to some of these ideas, all of them in order, or even all of them at once:
- ‘My life is full of love. I want to have children to share that.’
- ‘I’ve missed out on so much fun. I want to have more adventures without children first.’
- ‘Life is so short and can be taken away quickly. I want to have children earlier than I thought.’
- ‘My body has been through a lot. I want to love myself again first before I think about having children.’
- ‘I thought I knew what I wanted. Life has been intense and now I’m not so sure...’
Having a new perspective after transplant isn’t uncommon. Don’t panic about feeling conflicted, confused or overwhelmed by your priorities changing. Stay open to your options , and remember to talk with family, friends or a counsellor about how you’re feeling. Some of these thoughts and emotions might feel difficult to cope with, but support is available.
The treatment [using an egg donor] was successful. This meant I was able to have a child who is biologically related to my husband, who I carried and gave birth to. She’s now two years old. To me, this is very different to what I thought could happen when the phrase ‘permanent infertility’ was used about my situation.
Jacqui, who had a stem cell transplant
What are my fertility options before a stem cell transplant?
Before you have a stem cell transplant, you might be able to preserve your fertility through certain sex cells and tissue. We recommend following this general advice before your conditioning therapy and transplant:
- Speak to your medical team as soon as possible about the likelihood of negative effects on your fertility.
- Find out about your options for preserving your fertility. Is there time for you to carry these out? Can you delay your stem cell treatment, or is it very urgent? Will you need to pay for preservation treatment?
- Take time to talk to partners, family or friends about your feelings and options. If you’re in a relationship, your partner should also be involved in any decisions about your options.
- Ask to be referred to a fertility clinic, if there’s time. This might be within your hospital or outside of it. Or you might want to explore private options as well as the NHS.
How can I preserve my fertility before transplant?
It’s possible to collect and freeze your:
- sperm
- eggs
- testicular tissue (if you haven't yet gone through puberty)
- ovarian tissue (both before and after you've gone through puberty)
- embryos, which are eggs fertilised with sperm.
You can read more about methods of fertility preservation on the Macmillan website.
Are there any complications with fertility preservation?
Before your stem cell transplant, there are potential complications with collecting and freezing certain types of tissue. It’s important to be fully aware if you’re considering any of these treatments:
- Collecting and freezing sperm is a much quicker process than for eggs, ovarian tissue or testicular tissue.
- It can take a few weeks to go through the process of collecting eggs. First, you need to have injections to increase the number of eggs released from your ovaries. You might hear this called ‘ovarian stimulation’. Bear in mind you might not have enough time before transplant to have your eggs collected. But collecting ovarian tissue might be a quicker option, if it’s available.
- Depending on funding in your area, the NHS might cover the costs of freezing for a certain amount of time before you start paying. If you opt for private treatment, you’ll pay from the start. The average cost to store eggs for example can be up to £350 per year. And the average cost of private fertility preservation from start to finish usually costs between £7,000 and £8,000 in total.
- Collecting and freezing testicular tissue and ovarian tissue for future pregnancy is in the early stages of research. In this option, doctors collect tissue through a surgical procedure before freezing it. It's then thawed when required and transplanted back to roughly the same sites it was taken from. There’s not yet clear evidence of successful pregnancies using these types of tissue.
Important!
If you need a stem cell transplant very quickly, you might not have time to preserve your fertility before treatment starts. This is why it’s crucial to have conversations about your fertility as soon as possible after diagnosis. Your medical team will advise on what’s best.
Whatever happens, remember that decisions about your fertility are important. It’s OK to ask your team to explain things in detail.
Ahead of treatment, absolutely make sure to ask your medical team about fertility and potential impact, in order to do whatever is possible to have fertility options in the future. It’s been a long journey from my treatment to being ready to grow our family. It’s important that you and your partner are ready and prepared, and have support from those around you through a physically and emotionally tough journey.
Richard, who had a stem cell transplant
Remember:
LGBTQIA+ people should have equal access to fertility preservation. Your identity should not affect access, treatment and support offered to preserve your fertility.
What are my options for having children after stem cell transplant?
After a stem cell transplant, you might have options available if you already preserved your fertility before treatment. But there are also other options, both for your own fertility and for having children in other ways. In this section, we have information on:
- In vitro fertilisation (IVF)
- Donor eggs, sperm or embryos
- Natural conception
- Surrogacy
- Adoption or fostering
Before considering your options, we also have some general advice for thinking about having children after transplant:
- Look after yourself first. Recovery after transplant is tough and you need to take things one step at a time.
- Your partner, family or friends might be able to do some research, or have conversations with your medical team or fertility clinic. They can help to work out any possible next steps while you focus on recovery.
- When you’re ready, ask your medical team to arrange some tests to check if your fertility has been affected.
- Medical professionals generally recommend you wait about two years before trying to get pregnant.
- Keep talking to people around you. It can be complex, frustrating and lonely to go through fertility issues. Make sure to talk openly with your loved ones, medical team and organisations like The Daisy Network.
Do I have to pay for fertility treatment?
Your fertility treatment might be fully or partly funded, or sometimes you have to pay for it. The cost of getting fertility treatment after stem cell transplant might depend on:
- where you live
- whether you go through the NHS or a private clinic
- your circumstances – for example, LGBTQIA+ couples sometimes have to opt for private support first.
Your GP or medical team can help you find out what free NHS options are available in your area. Your local NHS might pay for a certain number of ‘rounds’ of IVF, or might have certain criteria on who can access free services.
If you choose to go to private, you can avoid waiting times and NHS criteria, but will have to pay. Sometimes this can cost a lot of money, so it’s important to think about the potential total if you might need multiple rounds of treatment.
Can I have IVF?
When you’re ready to have children after stem cell transplant, your own eggs, sperm or embryos can be used for ‘in vitro fertilisation’ (IVF). To do this, you will have had to collect and freeze these before your conditioning therapy and transplant.
IVF is when eggs and sperm are combined together outside of the body, usually in a laboratory. This process usually takes place in a dish, in very specific lab conditions. If IVF is successful, embryos will form. Doctors can then put an embryo inside someone’s womb to attempt to carry the pregnancy.
Depending on who’s most physically suitable, the person who carries the pregnancy could be:
- yourself
- your partner
- a surrogate.
To find out more about how IVF works, you can visit the NHS website.
Can I use donor eggs, sperm or embryos?
After stem cell transplant, you could explore using donor eggs, sperm or embryos if either you or your partner:
- were unable to freeze your own eggs, sperm or embryos
- are able to carry a pregnancy, even with damaged ovaries.
You can choose a donor based on physical attributes. All potential donors go through medical checks before they can donate. You can also choose someone you know to be screened as a potential donor, if they agree to this.
In the UK, there’s generally a shortage of donors. But your fertility clinic will be able to advise whether donation is a good option for you. You will then need to get IVF to use a donor’s eggs, sperm or embryos to have a baby.
Can I still conceive naturally?
After conditioning therapy and stem cell transplant, you might still be able to have a baby without support like IVF or a donor.
After your stem cell transplant, your medical team will advise on when you can safely try to get pregnant, or get someone else pregnant.
In general, health professionals tend to advise waiting at least six months to allow your body to recover from treatment. But some might advise waiting two years after treatment. This is because you’re less likely to relapse after two years.
If you’ve had a stem cell transplant and then later become pregnant, there’s no evidence to suggest this might harm your growing baby. However, there is some evidence to suggest that:
- you might go into labour and deliver your baby earlier than full-term
- you might need to deliver via caesarean, also known as a C-section
- your baby might be a lower weight than average at birth.
For these reasons, doctors might consider you high risk. They should monitor you closely throughout your pregnancy.
Can I use a surrogate?
Having a surrogate is getting someone else to carry a pregnancy and give birth for you.
This might be an option after transplant if you froze your eggs, sperm or embryos, but neither you nor your partner can carry a pregnancy. But it’s also possible to use donor eggs, sperm or embryos, or use an egg from your surrogate. You can find information, stories and advice on the Surrogacy UK Foundation website.
Can I look into adoption or fostering?
If you can’t conceive naturally, and don’t want to have fertility treatment or a surrogate, but still want children, you could consider adoption.
In the UK, the adoption process is not always simple or straightforward. You have to pass tests, including medical tests, which might make it feel long and frustrating. But it could be an option worth exploring.
You can also look into fostering a child or young person, which might be short term in a lot of cases, but can feel just as rewarding.
If you’re interested in fostering or adoption, speak to your local social services or a charity like Adoption UK.
All the sources I found said the same thing: 'If you've had a stem cell transplant, you'll probably be permanently infertile.' This message isn't helpful. I understand that they are not wanting to give false hope. But it assumes that 'fertility' is understood by everyone to mean 'having a child with your own eggs'. I understood it to mean my uterus was somehow ruined and useless, which wasn't true.
Jacqui, who had a stem cell transplant
Who can I talk to about my fertility concerns?
If you’re worried about your fertility after stem cell transplant, it’s important to talk to your medical team as soon as possible. You should have the first conversation before your conditioning treatment.
Your medical team can also refer you to a fertility clinic. You can access a clinic in different ways:
- you might get an NHS referral, but the options will depend on the area you live in
- you can find private clinics on the Human Fertilisation & Embryology Authority website.
It’s important to have conversations as soon as you can, because it can take time to go through the fertility preservation process. For example, it can take a few weeks to have your eggs collected, but you might not have enough time before you need your transplant. While it’s a quicker process to collect ovarian tissue, and even quicker to collect sperm, any option should still be organised as soon as possible.
What if I find it hard to talk about fertility?
Talking about your fertility can make you feel very exposed and vulnerable. Lots of difficult thoughts and feelings might come up, like feeling:
- embarrassed to talk about such a sensitive and personal topic
- ungrateful if you’re asking to delay your transplant
- guilty if you feel your fertility is not as important as your stem cell transplant, or vice versa
- concerned that being LGBTQIA+ might make it harder to access treatment, even though you should have equal access to services
- dismissed by medical professionals, partners, family or friends.
If you’re finding it hard to work out what you might want to know, here are some questions you could ask your medical team:
- Is my fertility likely to be affected by having a stem cell transplant? In what way?
- When will I know if my fertility is affected after transplant?
- What are my fertility options if the transplant causes these effects?
- Can I be referred to a local fertility clinic before/after my transplant?
- Is it possible to delay my transplant to have fertility preservation treatment?
- Are there ways to test my fertility again after transplant?
- Is there anyone I can talk to about my fertility worries, like a counsellor or fertility specialist?
You have every right to feel your fertility is as important to you as your stem cell transplant. Make sure you have all the information you need about options available to you. This will enable you to make the best decisions for your own health and future.
Should I talk to my partner, family, or friends about my fertility?
It’s important to talk to people close to you about your concerns with fertility and stem cell transplant. You don’t have to go through this alone.
You might have to make some hard decisions or have difficult conversations with your medical team. You might feel more supported through this if you keep your loved ones well informed and on your side.
It can still feel hard to have these conversations with certain people close to you, like your partner. On our page about sex after transplant, we have some tips and advice for how to talk to your partner if you feel nervous.
Emotionally, being left infertile only really hit me well into treatment, and particularly the physical and emotional toll it's then put on my partner, which is a tough thing to work through.
Richard, who had a stem cell transplant
Do young people need to worry about fertility problems in the future?
Having a stem cell transplant can affect anyone, at any age. If you’re a teenager for example, you’re already going through a lot if you need a transplant. Thinking about your future and the possibility of having your own children is probably the last thing on your mind. This type of decision will feel overwhelming, and being a teenager is already difficult enough.
While you might not act on your decision until years later, it’s important to make sure you talk about fertility before your transplant, even if you don’t know whether you want children or not in the future.
If you’ve been through puberty, you should have the same options as adults. Jump back up to our information on options for preserving your fertility.
Some cancer charities offer information and support for young people in similar situations. You might find their information relatable even if you don’t have a cancer diagnosis:
- The Children & Young People’s Cancer Association – Fertility after cancer treatment
- Teenage Cancer Trust – How cancer treatment can affect fertility
- Young Lives vs Cancer – Will cancer treatment affect my fertility?
My 15-year-old self just thought ‘I’m losing my hair. I’m going to park [fertility] for now and deal with it a bit later.’ Last year, it hit me that I hadn’t really thought about it. I’m not ready to cross that bridge at 18, but when I do, I’ll be talking to my doctors again.
Kate, who had a stem cell transplant when she was a teenager
If you don't want to have a baby, remember to use contraception.
You might still be able to get pregnant, or get someone else pregnant, even if you have:
- missed periods or they’ve stopped completely
- a low sperm count or have been told you no longer produce sperm at all
- been told you’re unlikely to get pregnant without support such as IVF.
Should I worry about my child’s fertility if they’re having a transplant?
It might feel surreal to think about your child’s fertility when they’re so young. Whether they can have children in the future is something you might not usually think about until their adulthood.
But it might feel even more surreal to face this when they need a stem cell transplant to save their life. In this situation, you might find yourself thinking:
- 'I just want my child to survive.'
- 'I want my child to have a future, full stop – I don’t care what that looks like.'
- 'I have so much to think about. Their fertility is not on that list.'
- 'My child is just a child. I shouldn’t be thinking about their future fertility.'
- 'How am I meant to make these big decisions for my child?'
- 'My child is too young to understand. How do I explain this to them?'
You might relate to all, some or none of these thoughts. Whatever you’re thinking or feeling, this is valid. It’s a complex and overwhelming situation.
When it comes to stem cell transplant, the overall treatment is less likely to affect your child’s future fertility because they’re young. But your child’s medical team will know their situation best, so make sure to discuss it with them.
If you feel ready to consider their future at this stage, you have several options for preserving your child’s fertility:
If your child has been through puberty
- Doctors can collect sperm, like they can for adults. This can be done by masturbation if your child is able to, or in a procedure while they’re sedated or under general anaesthetic.
- Doctors can collect eggs or ovarian tissue, in the same way as adults.
If your child has not yet been through puberty
- Doctors can collect testicular tissue, as your child will not yet produce sperm. This procedure is in the early stages of research and involves minor surgery. It has no clear evidence of success.
- Doctors can collect ovarian tissue. Ovarian tissue contains immature eggs which can be put back after stem cell transplant. This is a relatively new treatment with no clear evidence so far of its success.
In these options, the tissue is frozen, then thawed when required and transplanted back to roughly the same sites it was taken from. Bear in mind it can cost up to £350 per year on average in the UK to keep tissue frozen for private fertility preservation. The NHS might fund or partly fund this in some situations.
It can be tricky to know what’s best for your child. Be sure to ask all the questions you have, express your worries, and explore every option with your child’s medical team.
Only by pushing hard for a fertility appointment did I discover that with HRT, my reproductive system could regain the necessary functions for me to have IVF with donor eggs. After preparing for this treatment, I was told by fertility experts that there would be a good chance of success – they were right. My daughter is now two years old.
Jacqui, who had a stem cell transplant
What if I'm pregnant and need a stem cell transplant?
If you’re pregnant at the time of finding out you need a stem cell transplant, your medical team will know the best course of action.
You might be able to delay your conditioning therapy and transplant, or this might not be possible. It will depend on your diagnosis, prognosis and how far along you are in your pregnancy.
There are some general guidelines around safety for how long you’ve been pregnant:
- From 0 to 14 weeks pregnant. You should not have conditioning therapy, as this can harm the development of your baby.
- From 14 to 37 weeks pregnant. You might be able to have certain types of conditioning therapy.
- Over 37 weeks pregnant. You should not have conditioning therapy at all. Your medical team might however induce you to deliver your baby early, if it’s safe to do so.
You might have to make some very difficult decisions if you’re pregnant and need a stem cell transplant. Before you decide anything related to you or your baby, make sure you have:
- all the information you need from your medical team
- discussions with your medical team and people close to you, like your partner if you have one
- lots of support from family, friends, and any other networks or support organisations.
The doctors were absolutely amazing. They had experience of giving chemo to pregnant women which meant that they gave me specific drugs with certain molecules so the chemotherapy would not pass the placenta.
Sophie, who had a stem cell transplant after giving birth prematurely to her son, Freddie
Can stem cell therapy improve fertility?
Stem cell therapy is a treatment area undergoing lots of research – there’s still plenty that we don’t know. Some researchers think stem cell therapy might be able to help people with fertility issues to get pregnant.
Anthony Nolan only supports people going through stem cell transplant, not stem cell therapy. We encourage you to do your own thorough research on this if you’re trying to have a baby.
Where can I find information and support for fertility and stem cell transplant?
Hopefully you’ve found some helpful information and support on this page. If you’d like to find out more, there are dedicated charities and organisations offering information, support and community networks.
Some of these resources are for people with cancer diagnoses, but you might find them helpful even if you have a diagnosis for something else.
You can look into any of these organisations to find out more:
- Cancer, Fertility & Me offers information and support on fertility and cancer, including help on how to make decisions about your fertility and treatment.
- Daisy Network offers information, support, and a community for people diagnosed with Premature Ovarian Insufficiency (POI). You can also share your story or connect with others going through similar experiences.
- The Fertility Foundation offers emotional and financial support for anyone struggling with fertility issues.
- The Human Fertilisation & Embryology Foundation is a regulator giving impartial and accurate information on private fertility clinics and treatments in the UK.
- LGBT+ Mummies supports and advocates for LGBT+ women in parenthood.
- Macmillan has lots of information on how cancer can affect fertility, and support services including a helpline, webchat, and online community if you want to talk about things further.
- The NHS website has information on infertility and how to get support on the NHS.
- Shine Cancer Support has two podcasts about cancer and infertility, featuring information and stories from experts and patients. You can listen to Talking about fertility: Part 1 and Talking about fertility: Part 2, Stories of Infertility after Cancer on their website.
Can I get further support from Anthony Nolan?
If you or a loved one are worried about fertility after stem cell transplant, Anthony Nolan can support you in different ways:
- Our Patients & Families Forum and Facebook page are full of stories, information, and other people who are going through similar experiences.
- You can listen to our podcasts or read our blog.
- Call 0303 303 0303 or email patientinfo@anthonynolan.org to speak to our lovely, supportive team. We’re here for you.
Information last updated: 26/06/2026
Next review due: 26/06/2029