Fertility, Pregnancy and — Contraception on Olaparib

Your oncologist or treatment team will advise you on which methods are appropriate for your situation. As a general principle, one highly reliable method — or two complementary methods used together — is the standard approach. Hormonal contraception is generally acceptable for most women on olaparib unless there is a specific reason not to use it, such as a hormone-sensitive cancer. Ask your team to confirm which methods apply to you, because the answer can depend on your cancer type and other medicines you are taking.

Not immediately. You must wait until the washout period has passed — 6 months after your last dose if you are a woman, or 3 months if you are a man. After that, the decision to try for a pregnancy is one to discuss carefully with your oncologist, taking into account your overall health and cancer status. There is no single answer that applies to everyone, and it is worth having that conversation before you finish treatment rather than at the end of it.

The evidence is not yet complete, and this is an area where we do not have definitive long-term data. Olaparib may affect egg and sperm quality during and after treatment, but whether this reverses over time varies between individuals. This uncertainty is exactly why fertility preservation — egg freezing, embryo freezing or sperm banking — is recommended before starting, not as something to arrange later. If fertility matters to you, act on that conversation before your first dose.

Tell your oncologist immediately. The prescribing guidance requires men on olaparib to use contraception to prevent a partner becoming pregnant, because olaparib can be present in semen. If a pregnancy has already occurred, your oncologist needs to know so they can advise you and your partner on the next steps. Do not stop olaparib without discussing it first — that decision needs to be made together with your medical team.

This is a question your oncologist will answer based on your specific clinical situation. For most postmenopausal women, pregnancy is not a concern. However, confirming menopausal status clinically — rather than assuming it — is part of the prescribing assessment for olaparib. Your team will tell you directly whether the contraception requirement applies to you. If you have any doubt, ask them explicitly rather than assuming it does not apply.

Contact your oncologist the same day. Olaparib belongs to a class of medicines known to carry a risk of fetal harm based on its mechanism of action and animal studies, which is why pregnancy testing before starting is part of the prescribing process for women of childbearing potential. If you were already taking olaparib when the pregnancy occurred, your team needs to discuss the situation with you urgently. Do not stop the medicine without that conversation.