Medical Oncologist
Lenvatinib and reproductive health
Fertility, Pregnancy and — Contraception on Lenvatinib
Lenvatinib is not safe to take during pregnancy, and it requires effective contraception — not just while you are taking it, but for a set period after you stop. The length of that period depends on whether you are female or male.
Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed August 2026
- Not safe in pregnancy — Lenvatinib is expected to cause fetal harm based on how it works and on animal studies.
- Contraception is required — Effective contraception is needed throughout treatment and for a set period after your last dose.
- The washout period differs by sex — Females need 30 days after their last dose; males need 95 days. If you are planning a pregnancy, this difference matters.
- Fertility questions have a time window — If fertility preservation is important to you, raise it before starting treatment, not after.
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Lenvatinib can cause serious harm to a developing baby and must not be taken during pregnancy. Females of reproductive potential need effective contraception during treatment and for 30 days after the last dose. Males with a female partner who could become pregnant need contraception for 95 days after their last dose. Discuss the specifics with your oncologist before starting.
Can you take lenvatinib if you are pregnant?
No. Lenvatinib is not safe during pregnancy. Animal studies have shown it causes harm to developing fetuses, and because of how the drug works — partly by blocking new blood vessel formation — the same effect is expected in humans.
A developing pregnancy depends on new blood vessel growth to form the placenta and nourish the fetus. Lenvatinib directly interferes with that process.
If you discover you are pregnant after starting lenvatinib, tell your oncology team the same day. Do not stop the drug yourself without speaking to them first.
How do the requirements differ for females and males?
| Requirement | Females of reproductive potential | Males with a female partner who could become pregnant |
|---|---|---|
| Contraception during treatment | Yes, throughout the full course | Yes, throughout the full course |
| Contraception after last dose | Continue for 30 days after the final dose | Continue for 95 days after the final dose |
| Pregnancy test before starting | Yes — recommended before the first dose | Not required |
| Breastfeeding | Not recommended during treatment or for 30 days after last dose | Not applicable |
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Can lenvatinib affect my chances of having a baby in future?
What contraception do I need while on lenvatinib?
The prescribing guidance specifies highly effective contraception — barrier methods alone are generally not considered sufficient for this level of protection. Many people use a combination, such as a hormonal method alongside a barrier method. If you are unsure whether what you currently use qualifies, ask your oncology team or gynaecologist before your first dose. Lenvatinib can also affect thyroid function, and thyroid changes can sometimes affect how certain hormonal contraceptives work, so let your team know exactly what you are using.
What if I become pregnant while taking lenvatinib?
Tell your oncology team the same day. Do not stop the drug yourself without speaking to them — stopping a cancer treatment suddenly carries its own risks that your team needs to weigh. If you become pregnant during treatment or in the washout period after stopping, your team will advise on next steps and may refer you to a specialist. This is not a situation to manage alone, to delay reporting, or to save for your next scheduled appointment.
Does lenvatinib permanently affect fertility?
Animal studies have shown effects on reproductive organs, but what this means for long-term human fertility is not yet fully established. We do not yet have robust long-term data in people. For most patients, the greater risk to fertility comes from the underlying cancer or from other treatments such as certain chemotherapy regimens. If having children in future matters to you, raise it with your oncologist before starting treatment — that conversation is more useful then than after.
Can I preserve my fertility before starting lenvatinib?
Yes, and this is worth asking about promptly if it matters to you. Egg freezing for females and sperm banking for males are both possible before starting treatment, but these procedures take several weeks, and starting treatment may not be able to wait that long depending on your situation. Ask at your next appointment whether there is time, and whether a referral to a reproductive specialist can run alongside your pre-treatment workup. Do not assume there is no time without asking — the answer depends on your specific case.
Can I breastfeed while taking lenvatinib?
No. Breastfeeding is not recommended while taking lenvatinib, nor for 30 days after your last dose. Lenvatinib is present in breast milk in animal studies, and the potential risk to a nursing infant means the guidance is consistent: do not breastfeed during this period. If you have recently delivered and are about to start lenvatinib, speak to your team and to a lactation specialist so a feeding plan is in place before your first dose.
Did you know?
The reason males need contraception for 95 days after their last dose — more than three times as long as females — is that a full cycle of sperm production takes approximately 70 to 90 days.
Sperm developing during treatment may carry drug exposure for weeks after the final dose, which is why the washout window is longer.
Source: Lenvima (lenvatinib) prescribing information
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Common questions
Frequently asked questions
Can I start lenvatinib if I am currently pregnant?
No. Lenvatinib is contraindicated in pregnancy. If you discover you are pregnant and your oncologist is considering this treatment, they will need to discuss your options carefully — weighing the urgency of treatment against the risk to your pregnancy. That conversation must happen before any decision is made. If you are already taking lenvatinib and find out you are pregnant, tell your team the same day.
How long after stopping lenvatinib can I try for a baby?
The prescribing guidance advises waiting at least 30 days after your last dose if you are female, and at least 95 days if you are male with a female partner who could become pregnant. These are minimum washout periods based on how long the drug is expected to remain in the reproductive system. Your oncologist may advise waiting longer depending on your treatment history and overall situation. Discuss this before stopping treatment rather than deciding independently.
What type of contraception is recommended during lenvatinib treatment?
The guidance specifies highly effective contraception — barrier methods alone are generally not considered adequate. Your oncology team or gynaecologist will advise on the most appropriate option for you, taking into account your overall health and any thyroid effects from the treatment. If you are unsure whether your current method qualifies, ask before your first dose rather than assuming it is sufficient.
Will my periods come back after I stop lenvatinib?
This varies between individuals. Lenvatinib can affect hormone levels partly through its effects on thyroid function, and thyroid changes can disrupt the menstrual cycle. For some people, cycles return once treatment ends and thyroid function stabilises. For others, the underlying cancer or other treatments are the more significant factor. If your periods do not return within a few months of stopping and your thyroid is well-managed, let your oncology team know.
Does lenvatinib affect male fertility?
Animal studies have shown effects on male reproductive organs, but the implications for long-term human fertility are not fully established. The 95-day washout requirement for males is designed to cover the complete sperm production cycle — so that sperm exposed to the drug during treatment have been replaced before conception is attempted. If fertility matters to you, sperm banking before starting treatment is worth asking about. Your oncologist can tell you whether there is time.
My partner is taking lenvatinib. How long before we can try for a baby?
The prescribing guidance advises that males use effective contraception for 95 days after their last dose, to allow the complete sperm production cycle to turn over. Once that period has passed, trying to conceive is a decision to make together — ideally after a conversation with the oncology team about your partner's overall treatment status. If you are already pregnant and your partner is currently taking lenvatinib, let their oncology team know.