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Pregnancy and fatherhood on a TKI | CION Cancer Clinics
Becoming pregnant while taking imatinib or another TKI is usually avoided, because the tablet can harm a baby in early pregnancy. Many women with CML still have healthy children after planning a supervised break with their haematologist. Most men on imatinib can father children without stopping. This page explains the planning steps, what to do after an unplanned pregnancy, and what breastfeeding involves. At CION Cancer Clinics, every leukaemia, MDS and MPN case is reviewed by our haematologist and discussed at a tumour board before a plan is agreed.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Is it safe to get pregnant while taking imatinib?
- How is the advice different for women and for men?
- What are the steps in planning a pregnancy with CML?
- What should you do in each of these situations?
- What do families wrongly believe about CML and children?
- How do you raise this with your doctor and your family?
- Common questions about pregnancy and fatherhood on a TKI
The short answer
Is it safe to get pregnant while taking imatinib?
Becoming pregnant while taking imatinib or another TKI is not recommended, because these tablets can harm a developing baby, especially in the early weeks. Many women with CML still have healthy pregnancies, but it needs a plan made in advance with your haematologist.
Why the tablet matters in early pregnancy
TKIs block signals that the leukaemia cells use. Some of those signals also guide how a baby's organs form. The risk is highest in the first part of pregnancy, often before a woman knows she is pregnant. That is why reliable contraception is usually advised while you take a TKI.
What a planned pregnancy can look like
For some women whose CML is in a deep and stable response, the team may plan a supervised break from the TKI before trying to conceive. The BCR-ABL level is then checked often. If it rises, there are options that are considered safer in pregnancy.
What this page cannot tell you
It cannot tell you whether a break is safe for you. That depends on how deep and how long your response has been, which TKI you take and your obstetric history. Only your haematologist and obstetrician together can judge that.
If you find you are pregnant while taking a TKI, call your haematologist the same day. Do not stop or change the tablet on your own.Side by side
How is the advice different for women and for men?
Women taking a TKI
Men taking a TKI
Pregnancy on the tablet is usually avoided
Fathering a child on imatinib is generally considered possible
Reliable contraception is advised during treatment
Contraception advice depends on the TKI and your team's view
A supervised break may be planned before conception
Stopping the tablet is not usually needed
Breastfeeding while on a TKI is not advised
Sperm storage before starting can be discussed
Close monitoring through pregnancy and after birth
Routine CML follow-up continues as normal
Not sure whether this applies to you?
Ask an oncologistPlanning ahead
What are the steps in planning a pregnancy with CML?
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Tell your haematologist early
Raise it before marriage or at least many months before you want to conceive. The planning takes time, and your response needs to be stable first.
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Review your BCR-ABL trend
Your team looks at how deep your response is and how long it has lasted. A long, deep response makes a supervised break more realistic.
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Agree a plan with an obstetrician
A high-risk pregnancy team and your haematologist should agree who checks what, and when. Bring both teams' contact details to every visit.
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Supervised break and frequent tests
If a break is agreed, the tablet is stopped only on your team's instruction. BCR-ABL and blood counts are checked often while you try to conceive and during pregnancy.
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If the level rises
Your team may consider interferon, a medicine considered safer in pregnancy, or other measures. Restarting a TKI may be discussed later in pregnancy in some cases.
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After the birth
The TKI is usually restarted soon after delivery. This affects the choice about breastfeeding, which should be discussed well before the due date.
Your situation
What should you do in each of these situations?
The right step depends on where you are now. None of these involve changing your tablet without your team.
An unplanned pregnancy on a TKI
Call your haematologist the same day. Do not stop the tablet on your own and do not panic. Your team and an obstetrician will look at the timing, the TKI and your options together.
Diagnosed with CML while pregnant
This is uncommon and needs a joint plan quickly. Treatment is chosen to control the blood counts while protecting the pregnancy, often avoiding TKIs in the early months.
A man planning to become a father
Tell your haematologist. For most men on imatinib, no change is needed. With newer TKIs the evidence is smaller, so the advice may be more cautious.
Worth asking
- Whether sperm storage makes sense for you
- Whether your TKI has fatherhood data
Newly diagnosed and hoping for children
Mention it at the first visit, before the TKI starts. Egg or sperm storage can be discussed, and it may influence which TKI is chosen.
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Commonly believed
What do families wrongly believe about CML and children?
"A woman with leukaemia can never have a baby."
Many women with chronic phase CML have had healthy pregnancies with careful planning. It needs time, close monitoring and two teams working together, but it is often possible.
"The child will be born with CML."
CML is caused by a gene change that happens in the parent's blood cells during life. It is not inherited, and a child does not receive it from either parent.
"She should quietly stop the tablet once the wedding is fixed."
Stopping without supervision can let the leukaemia return, sometimes quickly. A break is only safe when your haematologist plans it and tests you often. Tell the team, even if the family would prefer to keep it private.
"The husband on imatinib must stop treatment to have children."
For most men on imatinib, this is not needed. Stopping brings its own risk to his health. The decision should come from his haematologist, not from family advice.
The conversation
How do you raise this with your doctor and your family?
Many people feel shy raising pregnancy or fatherhood with a cancer doctor. Your haematologist expects the question. Asking early gives you more choices, not fewer.
Questions to take to your appointment
Ask whether your response is deep and stable enough to consider a break, how often you would be tested, what happens if the level rises, and when the tablet would restart. Ask which obstetric team they work with. Write the answers down.
When families are arranging a marriage
CML in stable treatment does not prevent marriage or children, and it cannot be passed to a spouse. Honest conversations before a wedding avoid pressure to stop the tablet secretly later. A counsellor can help with this talk.
Who needs extra care
Women whose response has not yet been deep for long, those who have needed a change of TKI, or who have other pregnancy risks usually need a more cautious plan. For some, waiting longer is the safer choice. CION's haematology team can review your reports and coordinate with an obstetric team you choose.
Did you know
TKIs pass into breast milk. That is why the timing of restarting the tablet after birth and the decision about breastfeeding are planned together, well before the baby arrives.
Questions we are asked
Common questions about pregnancy and fatherhood on a TKI
I just found out I am pregnant and I take imatinib. What now?
Call your haematologist today and tell them how far along you think you are. Do not stop or change the tablet until they advise you. Many pregnancies exposed early have gone on normally, but each case needs individual review with an obstetrician, including scans to check the baby's development.
Can a man on imatinib father a healthy child?
Reports of children fathered by men taking imatinib have generally been reassuring, and most men are not asked to stop. The evidence for newer TKIs is smaller. Tell your haematologist you are planning a family so they can advise you based on your tablet and your response.
How long before trying to conceive should I plan?
Start the conversation many months ahead. Your haematologist first needs to see a deep and stable BCR-ABL response over time. The exact timing is individual, so there is no single waiting period that fits everyone. Planning early gives the team room to prepare a safe schedule.
Is interferon safe during pregnancy?
Interferon has been used to control CML during pregnancy because it is not thought to harm the baby in the same way TKIs can. It has its own side effects, such as flu-like symptoms and low mood. Whether it is needed depends on your blood counts and BCR-ABL results during pregnancy.
Can I breastfeed if I have CML?
Breastfeeding while taking a TKI is not advised, because the medicine passes into breast milk. Some women whose CML stays controlled breastfeed for a short time before restarting the tablet, under close monitoring. This is a decision to make with your haematologist well before the birth.
Does CML treatment affect fertility?
Most people taking a TKI are able to have children, though some studies suggest a possible effect on sperm or hormones with certain tablets. If fertility is important to you, discuss storing eggs or sperm before treatment begins, or ask for a referral to a fertility specialist.
Will pregnancy make my CML worse?
Pregnancy itself does not appear to make CML more aggressive. The risk comes from being off the TKI for a long time, which can let the BCR-ABL level rise. That is why frequent testing continues throughout pregnancy, so any rise is caught and managed early.
Is IVF possible for someone with CML?
IVF has been used by people with CML, but hormone treatment and egg collection need to be timed around the TKI and your response. The fertility team and your haematologist must plan it together. Never pause your TKI for fertility treatment without your haematologist's agreement.
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Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- Cancer Research UK — Chronic myeloid leukaemia (CML)
- Macmillan Cancer Support — Chronic myeloid leukaemia (CML)
- Leukemia & Lymphoma Society — Chronic Myeloid Leukemia
- Blood Cancer UK — Chronic myeloid leukaemia (CML)
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.
Keep reading
Related pages
Treatment-Free Remission: Who Can Try StoppingWhat a supervised break from the tablet involvesCML in Young Adults: Career, Marriage and InsurancePlanning the rest of life alongside CMLMajor Molecular Response ExplainedThe response level that makes planning possibleChronic Myeloid Leukaemia (CML)The overview of CML and its treatment
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Planning a family with CML?
Share your BCR-ABL reports with CION's haematology team. We will explain where you stand and help you plan with an obstetric team.