Before you begin treatment for cancer, it is important that you fully understand the potential for your therapy to cause infertility. However, if you're a man, it is equally important that you know that there are options for preserving your fertility.
Sperm cryopreservation is a term used to describe the freezing and storage of a sperm sample (also known as sperm banking). This is an extremely effective way for men to retain their ability to father a child in the future. It is widely available in most countries.
The sperm sample is most commonly collected from three sessions of masturbation, then frozen at very low temperatures for many years or until you are ready to use it. Even men with very low sperm counts may be candidates for sperm banking.
In order to get the best sample with the healthiest sperm cells, it is recommended to do the collection before the start of your cancer therapy. Start talking with your doctor about this as soon as possible following your diagnosis.
Testicular Shielding During Radiation Therapy:
During radiation treatments, shields are used to decrease the amount of radiation delivered to the testes. Depending on the area of your body that will receive radiation, this may not be feasible. However, if you do not require direct radiation to the testicles, shielding can greatly reduce the amount of radiation exposure and may prevent some fertility issues.
Testicular Sperm Extraction:
In testicular sperm extraction, a surgeon will remove a sample of tissue from the testicles. The tissue is examined and any sperm cells present are collected and frozen for future use. The frozen sperm are then used to fertilize egg cells in the same way as sperm banking. This method has been used experimentally on males who have not gone through puberty.
Testicular Tissue Cryopreservation:
The goal of testicular tissue cryopreservation, or testicular tissue freezing, is to return sperm-producing frozen tissue to the body after therapy. This method is still experimental.
While there is the potential for your cancer treatment to cause you to become infertile, there are a number of options to help you to keep your ability to father a child in the future. It is important that you discuss your options with your physician early for the best fertility preservation outcomes.
Krebs, L. “Sexual and Reproductive Dysfunction” in Yarbro, C., Frogge, M., Goodman, M., and Groenwald, S. eds. (2000) Cancer Nursing: Principles and Practice 5th ed.Jones and Bartlett: Sudbury MA. (pp.831- 854).
Lee, S., Schover, L. Partridge, A. et al. American Society of Clinical Oncology Recommendations on Fertility Preservation in Cancer Patients. Journal of Clinical Oncology 2006;24(18):2917- 2931.