When you are facing cancer treatment, you will find yourself with a lot of questions. If you are young or want to start a family, you may wonder how treatment will affect your ability to father children in the future. Certain cancer treatments may temporarily or permanently affect your fertility.
In a technique known as sperm banking, your sperm are frozen (called cryopreservation) and stored. Should you decide to become a father at some point in the future, you will have that opportunity, even if the cancer treatment has affected your fertility.
In order to bank your sperm, you will need to collect a sample of your semen. This usually takes place in a private collection room at a sperm bank. You may choose to collect the sample on your own or you may have your wife or partner come into the room with you.
Chemotherapy is designed to damage and kill cells like cancer cells that are dividing rapidly. Unfortunately cancerous cells are not the only cells in your body that divide rapidly. Some cells in your testicles are also doing this to create sperm. Chemotherapy can also damage them. It is quite probable that with chemotherapy, you will experience some period of infertility.
High doses of chemotherapy, such as those given before a bone marrow or stem cell transplant may cause permanent sterility. Radiation therapy, particularly whole-body irradiation or radiation aimed at or near your testicles, may also affect sperm production. Some cancer surgeries, such as those for prostate or testicular cancer, require men to have parts of their reproductive system removed. These surgeries may damage the nerves important for normal ejaculation.
If you know you are going to have cancer treatment, you may want to think about banking your sperm in advance, just in case you want it in the future.
The decision to bank your sperm is a highly personal one. If you are married or in a committed relationship, it is best if your partner is a part of your decision. If you are under the age of 18, you might want to discuss it with your parents.
Time however, is of the essence, as you will want to begin your treatment as quickly as possible. If you think sperm banking is an option for you, discuss the matter with your doctor soon after your diagnosis.
Storing semen samples does not have to delay the start of medical treatment, but it may temporarily delay your sex life. This is because sperm are constantly being produced in the testes and it takes some time to replenish the sperm level after each ejaculation. Therefore, to allow for high semen volume, a sample is best after 48 hours of sexual abstinence. If possible, the same amount of time should pass before the collection of the second sample. If the scheduling of your treatment does not allow that much time, waiting 24 hours between collections is usually enough.
When your semen sample is collected, it will be tested for quality, among other things. Semen quality is measured in one of several ways:
After you have finished your cancer treatment, your semen quality may not be what it was before your treatment. This is likely due to either the disease itself or the medications and therapies required to treat your disease.
Even if you have a low sperm count or low motility, it may make sense to bank your sperm. Fertility treatments like in vitro fertilization, sperm injection, or intrauterine insemination may help your partner to achieve a successful pregnancy.
Sperm can be safely frozen for up to 50 years if kept at a constant, low temperature. This means that sperm from a sexually mature teenage boy or a young man that is banked before his cancer treatment should be viable years later when he is ready to become a father.
Many children have been conceived with sperm that has been frozen. Currently, there is no evidence to suggest that pregnancies produced with frozen sperm increase the chance of birth defects.
When you have cancer, acting quickly is in your best interest. When talking about your treatment plan, ask your doctor about any concerns you have about your future fertility.
American Cancer Society
National Cancer Institute
About storing sperm. The Sperm Bank of California website. Available at: https://www.thespermbankofca.org/about-storing-sperm. Accessed November 20, 2014.
Fertility and men with cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/acspc-041228-pdf.pdf. Accessed August 19, 2016.
Male infertility. American Pregnancy Organization website. Available at: http://www.americanpregnancy.org/infertility/maleinfertility.html. Updated May 2016. Accessed August 19, 2016.
Male infertility. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/male-infertility. Updated July 2013. Accessed August 19, 2016.
Testicular cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 12, 2016. Accessed August 19, 2016.
Last reviewed August 2016 by Michael Woods, MD