Medical Oncologist
Before you start
Fertility referral before chemotherapy: why it cannot wait
Because everything that can be done to protect future fertility has to happen before the first dose. Chemotherapy can reduce or end the ability to have children, and once it has started there is nothing left to preserve. So the conversation belongs in the first days after the plan is made. If nobody has raised it with you, raise it yourself.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
17+specialists on panel
15,000+patients treated
35+centres across Telangana & AP
4.8★ / 800+Google rating
The short answer
Why can a fertility referral not wait?
Because everything that can be done to protect future fertility has to happen before the first dose. Chemotherapy can reduce or end the ability to have children, and once it has started there is nothing left to preserve. The door does not reopen later.
So the conversation belongs in the first days after the plan is made, not after cycle one. If nobody has raised it with you, raise it yourself — today rather than at the next appointment.
Ask even if you are unsure about children
This is the part people get wrong. A referral costs you one conversation and keeps the option open; skipping it closes the option permanently. Many people who felt certain at diagnosis feel quite differently two years later, and by then nothing can be undone.
It applies to men and women both
For men, the step is usually quick and straightforward. For women it takes longer and needs more planning. Both are worth asking about, and men are more often forgotten because their option is so simple that nobody remembers to mention it.
If you are being told there is no time, ask the oncologist directly how many days are genuinely available. Sometimes there are more than the first answer suggested.Who this is for
Who should have this conversation
- Anyone who has not completed their family
- Whether or not children feel like a present priority. The referral preserves a choice; it does not commit you to anything at all.
- Unmarried young adults
- The group most often skipped in India, because the subject feels awkward to raise with a family in the room. Ask to speak to the doctor alone if that makes it possible.
- Men of any age who may want children
- The option is simple and quick, and the window is still before cycle one. It is frequently not mentioned because it is assumed to be obvious.
- Women approaching their late thirties
- Here the timing question is sharper, and the honest answer may be that options are limited. That is still a conversation to have with a specialist rather than an assumption to make at home.
- Parents of teenagers and young adults
- The referral is standard practice for adolescents in many countries and is rarely offered here. Ask for it on your child's behalf.
- Anyone already having difficulty conceiving
- Say so. It changes what a fertility specialist would suggest and how quickly, and it is relevant information rather than a private matter to be kept back.
Not sure whether this applies to you?
Ask an oncologistWhat actually happens
How the referral works in practice
Four steps, and the first one is the only one that is genuinely urgent.
Ask, and ask today
Say plainly to your oncologist that you want a fertility referral before treatment starts. Ask how many days are available. This single sentence is the whole of the urgent part, and it is the step people postpone.
Useful wording
- "I may want children later. Who should I see?"
- "How long do I have before cycle one?"
See the specialist
A reproductive medicine doctor explains what is possible for you, given your age, your situation and the time available. They will be honest about what is and is not realistic. Nothing is decided in that room by anyone but you.
Ask about time and cost before agreeing
Both matter and both are often unclear. Ask how many days the process needs, what it costs, whether any scheme or insurance covers it, and what the ongoing storage charges will be.
Ask specifically
- Total cost, including storage each year
- Who to contact if payment lapses
Decide, including deciding against
Choosing not to proceed after a proper conversation is a perfectly reasonable outcome. What causes lasting regret is never having had the conversation at all, which is a different thing entirely.
Timing
Common worries, and the plain answer
The worry
The plain answer
"It will delay my cancer treatment"
Ask your oncologist what delay is safe; for many plans a short one is
"There is no time at all"
Ask how many days exactly, rather than assuming none
"It is too expensive to consider"
Ask the cost first; for men it is often modest
"I am not married, so it does not apply"
It applies to you; ask what is possible in your situation
"I can decide after treatment finishes"
Preservation cannot be done afterwards; only the decision can wait
"Nobody offered it, so I must not need it"
It is routinely not offered here; ask rather than wait
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Being straight with you
What this page cannot tell you
It cannot tell you whether your fertility will be affected. That depends on your drugs, the total amount given, your age and where you started from, and even then it is a matter of likelihood rather than certainty. Some people conceive naturally afterwards and some do not.
It cannot promise that a service is available or affordable near you. Reproductive medicine is unevenly distributed, waiting times vary, costs vary a great deal, and nothing here can promise you a place or a price. What it can tell you is that asking costs nothing and not asking is permanent.
It also cannot make the decision feel simple
Being asked to think about future children in the same week as a cancer diagnosis is genuinely difficult, and for many families it is tangled up with money, marriage and privacy. Take somebody with you whose judgement you trust.
What to do next
Say the sentence to your oncologist today: that you may want children later and would like a referral before treatment starts. Ask how many days are available. Ask about cost and storage before agreeing. And if you decide against it, decide after the conversation rather than instead of it.
Commonly believed
Four beliefs that close this door permanently
"Survival first. This can be sorted out afterwards."
Preservation cannot be done afterwards, which is what makes this different from every other question on the list. For many plans the delay involved is short, and your oncologist is the right person to say how short. Ask before assuming the answer is no.
"My periods will come back, so my fertility is fine."
Periods returning is reassuring but it is not the same as fertility being unaffected, and the reserve can be reduced even when cycles look normal. If children matter to you, have the conversation before treatment rather than reading the signs afterwards.
"It is not appropriate to discuss this with an unmarried patient."
Young unmarried adults are the group most often left out and the group with most to lose. If the subject is difficult in front of relatives, ask to speak to the doctor alone. The conversation belongs to the patient.
"It will be ruinously expensive, so there is no point asking."
Costs vary widely and for men the step is often modest. You cannot know without asking, and the asking is free. Find out the figure, including yearly storage, and then decide with real numbers rather than an assumption.
Questions we are asked
Common questions about fertility before chemotherapy
Will chemotherapy definitely affect my fertility?
Not definitely. It depends on the drugs, the total amount given, your age and where you started from. Some people conceive naturally afterwards. Because it cannot be predicted for you as an individual, the referral is worth having either way.
How long does preservation take?
For men it is usually quick and can often be done within days. For women it generally needs longer and some planning around the menstrual cycle. Ask the specialist for an exact answer and take it back to your oncologist.
Will it delay my cancer treatment?
Sometimes by a short period, and for many plans that is acceptable. Your oncologist is the one who can say what is safe in your case. Ask the question directly rather than assuming the answer is no.
What if I am not sure I want children?
Have the referral anyway. It keeps the option open and commits you to nothing. Deciding against it after a proper conversation is fine; never having had the conversation is what people regret years later.
Nobody has mentioned this to me. Is it too late?
Not if you have not started treatment. Ask today rather than at the next appointment. It is routinely not offered in India, so not being told is common and means nothing about whether it applies to you.
Is it covered by insurance or a government scheme?
Often not, and this is a genuine obstacle. Ask the clinic for the full cost including yearly storage charges, and ask your hospital's counsellor whether any support exists. Get real figures before ruling it out.
Can I use contraception during treatment?
You are usually advised to avoid pregnancy during the course and for a period afterwards, for both men and women. Ask your team which method suits your situation and how long the advice applies after the last cycle.
How do I raise this with my family present?
Ask for a few minutes with the doctor alone, or write the question on paper and hand it over. Staff are used to this and will not find it strange. It is your decision to make and your information to hold.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Sources
- Cancer Research UK — Cancer treatment and fertility
- Macmillan Cancer Support — Fertility and cancer treatment
- National Cancer Institute — Fertility Issues in People With Cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Talk to us
Need a fertility referral before treatment starts?
Tell us what has been found so far and we will help you reach the right specialist. One helpline serves every CION centre.