While cancer as a disease may not affect fertility, the treatments that are used to eradicate cancer can leave men infertile.
Cancer treatment and fertility in men
Before treatment begins, it is important to speak with your cancer team about fertility and the chances of conceiving after the treatment course is completed. Different cancer treatments have different effects on the body and the stem cells that need to be preserved in order for viable sperm to be produced. If your oncologist understands your desire to father treatment after surgery, the type of chemotherapy may be adjusted to decrease the chances of harming the production of sperm. If there is no other chemotherapy option, you can work with a fertility specialist on alternative fertility choices.
Holding off on conception
During the beginning stages of cancer treatment, sperm can become damaged and cause numerous health problems for a baby. It can even increase the chance of miscarriage. It is important to use male contraception during sex if you are undergoing cancer treatment. Contraception should be continued after cancer treatment until the doctor says it is okay for the patient to attempt to have children. Cancer treatments can affect the body for one year or longer after treatment is complete and could also affect the outcome of a pregnancy.
Treatment methods and male fertility
There are several different courses of treatment for treating cancer. The most common are radiation and chemotherapy. In some cancer cases, these two treatments will be combined to treat cancer more effectively.
Radiation and male fertility
Not all radiation will permanently affect male fertility. If the cancer is present in a part of the body other than the pelvic area, fertility may be preserved, but lessen for a bit of time. If the pelvis needs to be radiated, the chance of permanent damage to the stem cells and male fertility is very high.
Chemotherapy and male fertility
Chemotherapy treatment is not a final decision maker in terms of fertility. There is a range of chemotherapy drugs with some affecting fertility more than others. If chemotherapy is combined with radiation therapy, there is a higher chance of permanent damage to sperm production.
Other treatments and male fertility
The two other common cancer treatments are hormone therapy and surgery. Again, the fertility effects will be on a case by case basis. If the area treated is near the testes or involves the testes (for surgery treatment) fertility could be affected for a short period of time. Hormone therapy will also affect sperm production. Treatment for prostate cancer involves hormone therapy that can leave the patient with erectile dysfunction. The inability to achieve an erection will remain as long as the treatment is being administered. This effect could be temporary and should be discussed with the cancer treatment team.
Regaining fertility with testosterone
Men who have low testosterone due to cancer treatment may be able to regain fertility by using testosterone replacement therapy. The replacement of the testosterone will increase libido and improve erections for conception. If sperm production was not affected by cancer treatment, testosterone therapy could be the solution to male infertility after treatment has ended.
Preserving fertility
Although cancer treatments can leave you unable to produce viable sperm, it does not mean there are no fertility options. The most common option is sperm banking.
Sperm banking before cancer treatment
It is important for patients to store sperm before the cancer treatment begins. The sperm will be collected via masturbation into a container. This can occur in the sperm bank or at home. If the patient decides the collection should happen at home, the sperm sample will need to be delivered to the sperm bank within 30 minutes of sample collection. Storing more than one sample of sperm is advised.
Sperm collection can also be achieved with the removal of a small portion of testicular tissue or fluid. This process is effective in cases where semen production is limited or urethral damage has occurred.
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