If you or your male partner has been diagnosed with cancer, you may wonder “will we ever be able to have children?”. Fertility preservation for men is a new field of medicine that allows men to preserve their sperm and/or retain their fertility so they can still have children after cancer treatment.
Many factors determine a man’s fertility after cancer treatment, including his age, type of cancer, and types of treatment. It can take several years after cancer treatment before some men start to make healthy sperm again. Other men may be permanently sterile after cancer treatment.
Some good news is that cancer treatment often does not affect hormone function in men. In addition, sexual functioning should be normal after treatment.
Fertility preservation options during cancer treatment
Fertility preservation for men can take place during cancer treatment. For instance, during radiation treatment your doctor can minimize the dose of radiation used or aim the radiation away from certain organs in the reproductive system to protect a man’s fertility. This form of fertility preservation helps men remain fertile after treatment.
Unfortunately this technique may not work for young males. Radiation treatments near the pelvic region can affect a young male’s development before he reaches puberty, leading to future fertility problems.
Sperm freezing techniques help with fertility preservation
Many men undergoing cancer treatments want to freeze sperm for later use. One common method of fertility preservation in men is sperm freezing. Banking sperm before treatment is wise since both chemotherapy and radiation treatments can be harmful to sperm cells.
If your male partner chooses to bank and freeze his sperm, it may be best to bank several samples of semen, taken several days apart. While this could postpone the cancer treatment for a few days, it may be greatly beneficial later in life when you choose to have children.
Extracting sperm with fertility preservation
If you are concerned that the doctor will not be able to extract sperm from your partner’s ejaculate, know that there are ways around this issue. Doctors can do a biopsy of the testicles and withdraw sperm directly from them. With modern technology only a few sperm are needed to help you conceive. During high-tech treatments like in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI), more couples are able to conceive with just one sperm.
Other options for fertility preservation for men
Other techniques being studied include using hormonal medications to protect the testes and sperm from the harmful effects of chemotherapy and radiation. Researchers are also studying whether testicular tissue can be removed before cancer treatment and then repositioned later to offer fertility preservation. This type of fertility preservation would used for boys who undergo cancer treatment before puberty, since they could not produce sperm samples.
The future of fertility preservation
Currently, the diagnosis of cancer is not a diagnosis of infertility. Not all cancers will cause infertility, unless perhaps it’s testicular cancer. It’s far more likely that cancer treatments like chemotherapy and radiation will affect your fertility health. So that’s why it is important to discuss these fertility preservation options with your doctor.
Is fertility preservation right for me?
Maybe you’re not sure you want to have a child after your partner undergoes cancer treatment. The good news is that fertility preservation for men is quite simple. Your partner might consider banking a sperm sample since it is relatively easy and inexpensive. Later, he can choose whether to use his sperm, donate them to another individual trying to conceive, or have them disposed of.
At this time, it does not appear that cancer treatment will increase the risk of a couple’s future children having birth defects. Having children after cancer treatment also does not guarantee that your children will not get cancer, too. In fact, many cancers are not caused by genes, but are caused by environmental factors.
Sources: American Society of Clinical Oncology: “What to know: ASCO's Guideline on Fertility Preservation.” American Society of Reproductive Medicine: “Patient's Fact Sheet: Cancer and Fertility Preservation.” Johns Hopkins Medicine: “Risks of Infertility.” “Options for Men Before Treatment.” Oncofertility Consortium: “What can my doctor do to protect my fertility?” “What is "banking" sperm?” “How can cancer affect fertility?” “What if I decide to do nothing to preserve my fertility before undergoing cancer treatment?”
