5 Things to Know About Cancer and Male Infertility

When a man receives a cancer diagnosis in the time of life that he and his partner were planning to start a family, the couple is faced with a set of overwhelming new circumstances. While a cancer patient and his partner’s primary concern should undeniably be a focus on treatment and recovery, there are a number of things that couples in this situation who are hoping to have a child in the future should be aware of as they navigate treatment.

Listed below are five things that any man facing cancer should know about how treating the disease could affect his fertility.

1. Some, but not all, cancers and treatments can permanently impact a man’s fertility levels.

Whether or not a man experiences infertility because of this condition depends on many factors. These include the type of cancer he is diagnosed with, the form of treatment his oncologist recommends, the dosage and length of his treatment, the time that has passed since his treatment has ended, his age, and his personal health prior to diagnosis.

Radiation therapy and chemotherapy drugs targeted to any area of the body may all have an impact on a man’s reproductive health. The surgical removal of any organ that facilitates the transportation of sperm from the testes — such as both of a man’s testicles, bladder, or prostate gland — will cause sterility.

The presence of cancer in the body in general is likely to lower a man’s fertility temporarily. However, in some cases, infertility naturally resolves itself after time has passed after treatment. Cancers that pose a risk of permanent infertility problems include testicular cancer as well as Hodgkin disease, leukemia, and lymphoma.

2. Infertility from cancer treatment is rooted in three common causes.

The most common infertility problems in men who are treated for cancer are inhibited sperm production, erectile dysfunction, and abnormal hormone levels, all of which can be caused by targeted or hormonal therapies, radiation, or chemotherapy. Of the different forms of chemo, alkylating chemotherapy tends to have the most severe effect by causing germ cell loss and destruction, which in turn negatively impacts testosterone levels.

Men who are treated surgically for certain types of cancers may also be at risk of nerve or blood vessel damage to parts of the reproductive system responsible for ejaculation and maintaining an erection. Depending on a variety of personal and situational factors, the effects of infertility caused by cancer treatments may be temporary or permanent.

3. Doctors recommend that men wait before attempting to have a child after treatment.

The oncologist of a man who has undergone cancer treatment will likely suggest that the man waits for a period of time before attempting to start a family. How long he is instructed to wait will, as with many other areas concerning cancer and infertility, depend on the type of cancer he was diagnosed with and the form of treatment he received.

Oncology professionals will usually suggest waiting a minimum of at least one year post-treatment before trying to have a child. In cases where men are not affected by sterility, many can see a fertility specialist to have a semen analysis test done around the one-year mark. This will reveal if the effects of treatment on their testes have abated.

There is no medical evidence to suggest that the children of cancer survivors who are conceived after treatment are born with any negative health effects as a result of treatment. However, the chances of health problems occurring in a child are more likely if the baby is conceived during treatment or if a man does not wait for a long enough period of time after treatment has concluded.

4. There are fertility preservation options for men.

Men with a recent cancer diagnosis who wish to preserve their fertility prior to treatment should speak with a doctor about their options. For most men, the process of preserving fertility is simple, affordable, and effective. This process is performed by a man producing a sample of semen and having a sperm bank freeze and store it for as long as necessary. For the most part, a single sample of ejaculate can be banked for five years at a cost of around $500.

In some cases, it is also possible for men who are no longer able to ejaculate semen after treatment has already been performed to visit a reproductive urologist, who can collect a sample of viable sperm for use in IVF. The urologist performs a testicular sperm extraction, or TESE, by placing the man under anesthesia and performing outpatient surgery in which tissue is removed from the testes and examined to locate any sperm still alive inside.

5. There are resources for men and their partners to help ease the stress of this type of experience.

Receiving a cancer diagnosis is a traumatic experience in its own right, but the long-term effects of infertility caused by cancer can be one of the most emotional and difficult parts of the experience for men. Though it can be difficult to think about during a time of such upsetting news, a man and his partner may gain some peace of mind from talking with a fertility doctor as soon as possible after a diagnosis.

A fertility professional can help a man who has been diagnosed with cancer learn more about the ways he can improve his chances of becoming a father after treatment. Additionally, a doctor may be able to point the couple to professional support groups of people going through similar challenges or a counselor trained to help people process and work through these difficult situations.

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