The word “fertility” is used to describe the ability to have children biologically. Some cancer treatments can affect fertility. You may not yet be thinking about whether or not you want to become a parent someday. However, knowing about possible fertility effects of treatment now may help you take steps now to plan for the future.
Cancer treatment and fertility
Some fertility effects may last for a little while; others may be permanent. Risk for future fertility problems include your age at the time of your treatment, and the type and length of your treatment.
Some possible effects of cancer treatment
• High doses of radiation to the brain (and some chemotherapies) can affect your body’s ability to make sperm.
• Alkylating agents—like cyclophosphamide or procarbazine—have the biggest effect on fertility. Other drugs are generally less harmful to sperm-forming cells, but can still cause fertility problems, especially when used as part of combination medicine therapies.
• Higher doses of radiation may cause your body to permanently stop making sperm.
• If radiation is used on or near your testicles, your ability to make sperm could be affected for a while. But it could potentially return to normal later on. The effects of chemotherapy on sperm production may also be temporary.
• Radiation can affect testosterone, the male hormone. This side effect can either delay or speed up puberty. It may also affect your ability to have an erection.
Talk with your doctor if you think you may be going through puberty early (before age 13) or late (after age 15). The doctor may want to give you medicine to assist with the hormone balance. You can also talk with your doctor about a test to see if your body is making sperm.
Planning for the future
There are options that may be available to you to help you preserve your fertility. Some of these options require action to be taken before treatment begins, while others can wait until during or after treatment.
• Sperm banking. You may be able to donate sperm cells, which can then be frozen and stored. This is called sperm cryopreservation (or sperm banking or donation) and has the highest likelihood of success for male cancer survivors.
It may seem like an embarrassing topic, but your doctor or nurse will work with you to explain the process for collection and delivery, with your privacy in mind. Our specialists are comfortable talking about this—and can help ease any fears or discomforts you may have about the process of sperm banking.
• Radiation testicular shielding. If possible, the doctor can put a shield over your pelvic area to protect your reproductive organs from radiation.
Before or after treatment
• Testicular sperm extraction (TESE) Under general anesthesia (where you aren’t awake at all) a surgeon removes a small piece of tissue from your testicle. Any sperm cells found in the tissue can be removed and frozen for later use. TESE can be done before or after puberty. It is still considered an experimental procedure in boys that haven’t yet reached puberty.
• Donor sperm. When you are eventually ready to start a family, you can use sperm from an anonymous donor to produce a pregnancy through in vitro fertilization.
An important conversation on a sensitive topic
It is important to talk your oncologist about the fertility effects of your treatment, ideally before you start treatment. Our specialists can answer any and all questions—even the ones that feel embarrassing—about fertility preservation.
We will keep your concerns and private information confidential.
It is important to remember that even if you have been told by your doctor that you may have long-term fertility issues, it does not mean that you cannot get someone pregnant or get a sexually transmitted disease. So, always practice safer sex.