When men are diagnosed with cancer at a young age, the thought of future fertility comes to mind. Cancer not only affects the health and look of the outer body, but also the processes occurring inside the body. While cancer as a disease may not affect fertility, the treatments to eradicate the cancer may leave men without the ability to produce sperm and thus infertile.
Cancer Treatment and Fertility in Men
Before treatment begins, the man will need to talk with the cancer team and fertility and the chances of conceiving after the treatment course is complete. Different cancer treatments have different affects on the body and the stem cells that need to be preserved in order for viable sperm to be produced. If the cancer treatment doctor understands the patient's 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, the male cancer patient will then work with a fertility specialist on alternative fertility choices.
During the beginning stages of the cancer treatment, sperm can be damaged but still able to achieve conception. These sperm could create a baby with numerous health problems or increase the chance of miscarriage in the woman. It is important to use male contraception during intercourse while cancer treatment is being administered.
Contraception should be continued after cancer treatment until the doctor says it is okay for the patient to attempt to father children. Cancer treatments can affect the body for one year or longer after treatment if complete and could affect the outcome of a pregnancy.
Treatment Methods and Male Fertility
There are several different courses of treatment that may be used when treating cancer. The most common are radiation and chemotherapy. In some cancer cases, these two treatments will be combined to treat the 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 though 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 for cancer is not a final decision maker in terms of fertility. There are a range of chemotherapy drugs with some affecting fertility more than others. If the 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 if only on the short term. Hormone therapy will also affect sperm production. Treatment of prostate cancer involves hormone therapy that may 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 lowered testosterone due to the cancer treatment may be able to regain fertility by using testosterone replacement therapy. The replacement of the testosterone will increase libido and improve erection for conception. If the sperm production was not affected be the cancer treatment, testosterone therapy could be the solution to male infertility after treatment has ended.
Preserving Fertility in Men
Just because cancer treatment is going to leave the man without the ability to produce viable sperm does not mean there are no fertility options. The most common option is sperm banking.
Sperm Banking Before Cancer Treatment
It is important for the male cancer patient 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 a good idea.
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.