Fertility and Colorectal Cancer: What Young Adults Need to Know Before Treatment

A colorectal cancer diagnosis in your 20s, 30s, or 40s comes with questions most older patients never have to ask.

Can I still have children?

Will treatment affect my fertility?

Do I have time to preserve it?

These aren’t secondary concerns. For many young adults, they’re immediate and deeply personal. And they deserve to be part of the conversation from day one.

Why Fertility Comes Up So Often in Young-Onset Colorectal Cancer

Colorectal cancer diagnoses in adults under 50 have risen by 15% since 2004. Today, one in five new cases occurs in someone younger than 50.

Unlike older patients, many younger adults are still planning families — or haven’t started yet. That changes how treatment discussions unfold.

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“For young adults diagnosed with colorectal cancer, it is important to know that some treatments may affect future fertility. Meeting with a doctor early can help you understand and explore options such as sperm banking, egg freezing, or embryo preservation to protect your chance of having children. Your doctors can guide you through these decisions and support you in navigating this journey,” says Lauren Fink, MD, director of male infertility at Englewood Health.

How Colorectal Cancer Treatment Can Affect Fertility

Not every patient will experience fertility challenges — but certain treatments can increase the risk.

Chemotherapy

Some chemotherapy medications may affect egg or sperm production. In women, this can lower the number and quality of remaining eggs or trigger early menopause.

Radiation

Pelvic radiation can directly impact reproductive organs, potentially affecting future fertility.

Surgery

Certain rectal cancer surgeries may affect nerves involved in sexual function in men.

The impact varies based on age, type of treatment, and overall health. That’s why early planning is essential.

The Window Is Before Treatment Begins

Fertility preservation options may include:

• Egg freezing
• Embryo freezing
• Sperm banking
• Referral to a reproductive endocrinologist

In many cases, these steps can be completed quickly and without significantly delaying cancer treatment.

But once treatment starts, options may become more limited.

Why a Dedicated Program Matters

At Englewood Health, young adults diagnosed with colorectal cancer have access to a dedicated Young Onset Colorectal Cancer Program, designed to address the unique needs of patients under 50.

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“Too many younger adults are getting diagnosed with colon or rectal cancer,” says Michael Marco, MD, colorectal surgeon at Englewood Hospital and co-director of the Young Onset Colorectal Cancer Program at The Lefcourt Family Cancer Treatment and Wellness Center at Englewood Health. “The increase in cases among this population calls for a rethinking of how we deliver care and support patients and their families.”

The program brings together surgeons, medical and radiation oncologists, oncology navigators, genetic counselors, mental health professionals, and fertility specialists to create a coordinated care plan.

“Our Young Onset Colorectal Cancer Program was built around the realities younger patients face,” Dr. Marco says. “That includes fertility planning, genetic counseling, mental health support, and long-term survivorship care. We’re not just treating cancer — we’re supporting the whole person and their future.”

You Are Encouraged to Ask

When facing a cancer diagnosis, it can feel like everything must move fast. But conversations about fertility are an important part of planning your care — not a distraction from it.

If you are under 50 and newly diagnosed with colorectal cancer, talk to your care team about fertility before treatment begins.

Learn more about the Young Onset Colorectal Cancer Program

Posted on April 9, 2026