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Men: Protecting Your Fertility Before Cancer Treatment

Learning you have cancer can cause distress, anxiety, or depression. Many things can cause these feelings. You may have many questions, especially about treatment. You may also have questions about how cancer care may harm your ability to have children (your fertility). If you are thinking about having a child at some point, you can take steps to protect your reproductive health. Don't hesitate to talk with your healthcare providers about this or to share your fears or concerns. Your cancer care team can discuss available options with you. They can refer you to a reproductive specialist.

Cancer treatment and your fertility

Not all cancer treatments may affect your ability to have children. It depends on many things, such as:

  • Your age

  • The type of cancer you have

  • The kind of treatment you will have

  • The length and dose of that treatment

Here are a few ways that some treatments may affect your fertility:

  • Surgery. As part of your care, you may need to have certain organs or parts of them taken out. If this means reproductive organs, such as your prostate or testes, you may suffer from erectile dysfunction. Or you may have problems making sperm. Some surgeries done in your pelvic area may also harm these organs. That also could lead to fertility problems.

  • Radiation. High doses of radiation can kill cancer cells. This type of treatment may also affect nearby healthy cells. Radiation to your pelvis may cause changes in your reproductive organs. As a result, you may not be able to make semen or healthy sperm. If you have radiation to your brain, it may harm your pituitary gland. This gland may no longer work right. It may not make the hormones needed to tell your body to make sperm.

  • Chemotherapy. Some of these medicines can damage your testes. These organs may then no longer make sperm. This problem may last for months or years. Or it can be lifelong (permanent).

  • Other treatments. You may need other treatments that may affect your reproductive system. These include hormone therapy, stem cell transplants, and bone marrow transplants. Your healthcare provider can tell you more about the risks.

Questions to ask about fertility preservation

If you think you may want to have children after your cancer care, talk with your healthcare provider right away. It’s best to talk about your concerns before you start treatment. You may then have more choices for preserving your fertility. Your provider may also have you talk with a reproductive specialist.

These questions can help you start the conversation:

  • What is the chance that my treatment may affect my fertility?

  • What possible side effects could treatment have on my reproductive health?

  • What are my choices for protecting my ability to have children?

  • How long after treatment may my fertility be affected?

  • How much do fertility preservation methods cost?

Your choices for preserving your fertility

Your healthcare provider can help you choose the best way to protect your fertility. Be sure to ask about any risks. One of these methods may work for you:

  • Cryopreservation (sperm banking). This method includes freezing and storing some of your sperm. It may be thawed at a later time when you want to have a child.

  • Gonadal shielding. This option can protect your testes while you are having radiation. During treatment, your provider may place a lead shield on the outside of your body over your testes. Or he or she may be able to direct the radiation to a very small area.

  • Testicular sperm extraction. This procedure may be used if you can’t provide a sperm sample. Your provider will remove some sperm from your testicles. It can then be frozen for later use.

Researchers are studying new ways to protect the fertility of people who need cancer treatment. One of these may also be a choice for you through a clinical trial. Talk with your provider or reproductive specialist to learn more.

Date Last Reviewed: 4/1/2019
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