How may cancer treatment affect men's fertility? 

  • Stopping, or interfering with, the production of sperm in the testes.

  • Affecting the production of testosterone or others hormones involved in male fertility

  • Damaging nerves and blood vessels in the pelvic region, making it difficult to get an erection or ejaculate.

  • The need for surgical removal of the affected testis.

After treatment, fertility is often described in four ways:

  1. Normal Fertility
    Normal sperm function and count. Many men undergo cancer treatment and are able to father children naturally with no change in their fertility.

  2. Temporary Infertility
    No sperm in the ejaculate. Sperm production may stop for a temporary amount of time. It may return immediately or many years after the cancer treatments end.

  3. Compromised Fertility
    Compromised sperm function and/or count. This can occur due to impaired sperm production, interference with hormone production or damage to the nerves and ducts that carry sperm out of the body. This can make natural conception hard and may require the assistance of fertility doctors.

  4. Permanent Sterility
    No ejaculated sperm. Some men will no longer produce sperm after treatment. There may be low levels of sperm in the testicles that may be used to try to have children with help from a doctor.

What is involved in preserving fertility in men?

Sperm Banking is recommended for all men diagnosed with cancer where treatment is associated with risk of long-term damage to the testes. This involves producing a semen sample, usually by masturbation, in a medical centre (this is so that the sample can be taken to the lab as quickly as possible). As long as the sample contains some live sperm it can be frozen for up to 20 years without any further damage.

Data from the Human Fertilisation and Embryology Authority shows the success rate for pregnancy in women under 35 with previously stored sperm is approximately 19%.

Sperm storage usually happens after an orchidectomy, the surgical removal of the affected testicle, but before further treatment. Occasionally it may be offered before the orchidectomy, if you have already had fertility difficulties or the unaffected testicle is small.

Data suggests that only a third of men take up the opportunity to bank sperm at diagnosis, due to a variety of reasons. All of these are very individual points and can be discussed further with your oncologist, or other members of your care team.

  • It may not be something that seems important in comparison to your diagnosis

  • You may be single and not thinking of a family yet

  • Feel too young or too old

  • You may be concerned about it delaying the start of your treatment

Research carried out recently by Hammersmith Hospital has found that many men who have gone through cancer treatment live in the unknown as they fail to get retested after they have finished treatment. Monica Figuiredo, Male fertility, Clinical Nurse specialist who is carrying out this research, explains in our Trekstock video why it is important to be retested as soon as possible.