This information is meant to be a general introduction to this topic. The purpose is to provide a starting point for you to become more informed about important matters that may be affecting your life as a survivor and to provide ideas about steps you can take to learn more. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information.
What is male infertility?
Cancer and its treatment may sometimes put male survivors at risk for infertility. Infertility means not being able to produce healthy sperm or to ejaculate sperm. There are many different causes for infertility in cancer survivors. While it’s best to discuss your risk for infertility before treatment begins, there are still options for cancer survivors who may experience infertility as a result of cancer or its treatment but want to have children.
Infertility or even just knowing you have a risk of infertility may affect you emotionally. If you want to have children, it’s perfectly understandable that thinking about infertility makes you feel sad or upset. This document outlines the physical causes of infertility and options for survivors who may have difficulty having children. It does not explain how infertility can affect you emotionally, which is something you may want to discuss with a mental health professional.
If you are worried about infertility, set up an appointment with a urologist or other member of your health care team to discuss any concerns or questions you have about the information in this document.
What causes male infertility?
Men’s fertility can be damaged by many different factors. Some causes are listed below.
Which cancers are most likely to cause male infertility?
Some cancers are more likely to cause male infertility.
Which cancer treatments are most likely to cause male infertility?
Usually, the cancer treatment, not the actual cancer, damages a man’s fertility. Radiation and chemotherapy kill cells that are in the middle of dividing and growing, when they are easier to damage. Cancer cells divide much more often than most normal body tissues, so they are killed off while normal cells survive. However, hair and sperm cells also grow constantly, making them sensitive to chemotherapy or radiation.
What are the symptoms of infertility?
Men usually don’t have any symptoms of infertility unless they have dry orgasms. Most men don’t realize that they are infertile until they have a semen analysis and discover that their semen quality is low. If you are curious about your own fertility, you should get it tested.
How can a man’s fertility be tested?
A man’s fertility can be tested with a semen analysis: A sample of semen is collected very soon after ejaculation and is put under a microscope. The semen analysis usually includes at least three “scores” that make up semen quality:
When does cancer-related infertility start and how long does it last?
Generally, infertility is most likely to happen before cancer treatment and just after treatment is finished. Just because one year’s semen analysis says you are infertile, the results may change over the next month or year. If a man is going to recover sperm production, his semen analysis will usually improve within one to three years after he finishes cancer treatment, although some men have had improvements as many as nine years later.
What are some options for a survivor whose fertility was or will be affected by cancer or treatment for cancer?
Below is a brief list. For more information, see Suggestions.
Male Infertility: Suggestions
The suggestions that follow are meant to help you take what you learn and apply the information to your own needs. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Additional Resources section for more resources.
Below is a list of options for cancer survivors who are concerned about their fertility.
Cost: Most health insurance plans do not cover the cost of storing frozen semen although many do pay for the semen analysis. Many sperm banks have monthly payment plans to make banking more affordable for cancer survivors.
Who can do it: Men who have reached puberty, even boys as young as 12 or 13, can bank sperm as long as the semen contains enough live and healthy sperm.
Where to bank sperm: Most large cities have sperm banks that you can find listed in the yellow pages. A member of your health care team may be able to give you a referral. If a sperm bank is not located near your home, you can find sperm banks on the Internet. Ask a member of your health care team if the sperm bank is reputable.
Some sperm banks provide express mail kits to men who want to collect their semen at home. Some work with a local laboratory to process your sample and send it to the bank.
In Vitro Fertilization - Intracytoplasmic Sperm Injection (IVF-ICSI)
Cost: IVF-ICSI is expensive and involves some medical risks for the woman. But it is also very successful, especially if the woman has normal fertility and is younger than 35.
Who can do it: Since only a few sperm are needed, IVF-ICSI is a good option for men who have poor semen quality or have sperm with poor motility.
Intrauterine Insemination (IUI)
This option is for men with semen quality that is closer to normal.
Fertile Hope is a national, nonprofit organization dedicated to providing reproductive information, support and hope to cancer patients whose medical treatments present the risk of infertility. Fertile Hope is meeting the needs of cancer patients and survivors through programs of awareness, education, financial assistance, support and research.
RESOLVE: The National Infertility Association
RESOLVE: The National Infertility Association provides support, education and advocacy to those dealing with infertility. The website provides timely information related to all family building options, including assisted reproductive technology, third party donors, adoption, and living childfree. The website also provides information including: local RESOLVE support groups and educational events, state insurance coverage for the diagnosis and treatment of infertility, your regional RESOLVE, a variety of RESOLVE publications, as well as 10 online communities to chat with others.
LIVESTRONG SurvivorCare Program
LIVESTRONG SurvivorCare offers assistance to all cancer survivors, including the person diagnosed, caregivers, family and friends. The program provides education, information about treatment options and new treatments in development, counseling services and assistance with financial, employment or insurance issues. To provide these services, LIVESTRONG SurvivorCare has partnered with several organizations, including CancerCare, Patient Advocate Foundation and EmergingMed.
The LIVESTRONG Survivorship Notebook is a tool that can help you organize and guide your cancer experience. The portable, three-ring binder contains a variety of information covering a full range of physical, emotional and practical survivorship topics. You may order a free LIVESTRONG Survivorship Notebook at www.livestrong.org/notebook. Shipping and handling charges will apply.
This document was produced in collaboration with LIVESTRONG and Leslie R. Schover, PhD, Professor of Behavioral Science, University of Texas M.D. Anderson Cancer Center