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Fertility Options for Men with Cancer

May 02, 2017

Fertility Options for Men with Cancer

Kyle’s diagnosis of testicular cancer came as a shock to his family. He had always been a healthy guy with a bright future. He and his wife Emilia hoped to start a family within the next few years

So when Kyle felt an unusual lump during his last testicular self-exam, he knew he should go to the doctor. But he never expected to have cancer.

There are lots of men like Kyle. Sometimes, cancer strikes when men are thinking about fatherhood. It can also happen when men aren’t ready for children quite yet, or when they aren’t sure.

Cancer and its treatment can have a big impact on a man’s fertility. Men should know that, in some cases, fathering children biologically will be a challenge. However, there are also options available that provide hope.

How Does Cancer Affect Men’s Fertility?

For men, infertility usually stems from two situations: Either the body cannot produce enough healthy sperm to fertilize an egg cell, or that sperm cannot reach the egg cell. For example, some cancers, like Hodgkin’s disease and testicular cancer, affect sperm quality.

However, it’s often the treatment for cancer that is the main culprit. Here are some of the ways it can affect fertility.

Radiation. Some cancers are treated with energy rays that attack cancer cells. If radiation is pointed directly at the testes (the glands that produce sperm and testosterone), it can damage the stem cells needed for sperm production. Similarly, if the pituitary gland in the brain receives radiation, it may no longer be able to “tell” the testes to make sperm. This can occur even if steps are taken to shield these areas or if radiation is targeted to a nearby organ.

Chemotherapy. Chemotherapy drugs kill cancer cells, but they can also kill the stem cells involved with sperm production, leaving a man infertile. In some cases, sperm production may recover in time, but that can take several years. Some drugs are less toxic to sperm stem cells than others, and patients can ask their doctors about which drugs are most appropriate.

Surgery. Surgery’s effects on fertility can vary. For example, if a man with testicular cancer needs to have both testicles removed, he will no longer be able to produce sperm. But if only one testicle is affected, the remaining testicle might make enough.

Men who have their bladder removed often have trouble with fertility because the vas deferens, (a tube that creates the path for sperm to travel), is cut. While the testicles can still create sperm, that sperm does not leave the body with ejaculation. (Learn more about “dry” orgasms.)

What Are Men’s Options?

Men with cancer should not give up hope of starting a family. There are several options available, including the following:

Sperm banking. Frozen properly, sperm can be frozen for many years, even decades. Some men decide to bank their sperm before they start cancer treatment, even if they are unsure about fatherhood in their future. The process is fairly simple. Generally, the man masturbates in a private room at the sperm bank or clinic, either alone or with his partner. The sperm is collected and frozen until needed. At that time, it can either be placed into a woman’s uterus (intrauterine insemination) or injected into an egg cell in a lab (in vitro fertilization). If that latter method is chosen, the resulting embryos can be inserted into the uterus.

Men with fast-growing cancers, like acute leukemia, may not be able to bank their sperm if treatment begins immediately. Also, some sperm banks will not store the sperm of men who have HIV or hepatitis B.

Electroejaculation. This method is helpful for men who are unable to ejaculate or feel too anxious to do so in a clinic. The procedure involves using a light electrical current to stimulate ejaculation. This current is delivered through a special rectal probe. Once sperm is collected, it is frozen and stored at a sperm bank.

Adoption. If a man is unable to father a child biologically, adoption is another path for creating a family.

Learning More

If you are a man facing cancer treatment, it’s important for you to understand all your options. Your oncology team can put you in touch with fertility and family planning specialists who can advise you on your personal situation. If your doctor doesn’t discuss fertility with you, but sure to bring it up yourself. And know that you are not alone. Your team will be with you every step of the way. It can also help to talk to your partner, trusted family members and friends, or support groups to help you decide what is best for you.

For more information on fertility and cancer, we suggest these resources:

Alliance for Fertility Preservation / Fertility Scout

Livestrong.org

Resources

Alliance for Fertility Preservation

“Electroejaculation”

http://www.allianceforfertilitypreservation.org/electroejaculation

“Sperm Banking”

http://www.allianceforfertilitypreservation.org/sperm-banking

American Cancer Society

“Fertility and Men With Cancer”

(Page last revised: November 6, 2013)

https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/fertility-and-men-with-cancer.html

Livestrong

“Male Fertility Preservation”

https://www.livestrong.org/we-can-help/just-diagnosed/male-fertility-preservation#

OncoLink (Penn Medicine)

Vachani, Carolyn, RN, MSN, AOCN

“Male Fertility and Cancer Treatment”

(Last modified: July 25, 2016)

https://www.oncolink.org/support/sexuality-fertility/fertility/male-fertility-and-cancer-treatment