Sex and Cancer: Total body irradiation

Total Body Irradiation (TBI) is a type of radiotherapy that is often used with high-dose anti-cancer drugs to help prepare a patient for a stem cell transplant. If you have had a higher dose of chemotherapy and/or TBI, there is a higher risk of infertility.

TBI usually causes infertility for people registered female at birth. The radiation, along with the high dose chemotherapy, will mean that the eggs within the ovaries will be damaged. This also means that you may undergo permanent early menopause which can cause vaginal dryness and thinning of the vaginal tissues. This will happen gradually after your treatment. You might be referred to an endocrinologist after the transplant for hormone replacement therapy (HRT). 

Radiotherapy to the testicles (balls) almost always causes infertility. The radiation, along with the high dose chemotherapy you will have received, will stop the production of sperm. Before treatment begins you will be asked if you wish to store a sample of sperm for future use (sperm banking). 

These changes generally can’t be reversed and infertility will be permanent. If you planned to have children, this can be very difficult to cope with.

If you have had ovarian or testicular tissue cryopreservation there is a chance fertility can be restored. This is not the same as sperm or egg storage. Ovarian or testicular tissue cryopreservation involves an operation under anaesthetic to remove ovarian or testicular tissue, this can then be reimplanted at a later date.