As you may already know, chemotherapy and radiation therapy have the greatest impact on cells that rapidly divide. In males, the very early form of immature sperm cells in the testes called spermatogonia have a very fast division rate and are more sensitive to the effects of these types of therapies. The absence of sperm in the semen is called azoospermia. Without sperm cells in his semen, a man will be unable to father a child.
The more mature developmental stages of sperm cells are less likely to be killed by cancer treatment. So, it may take a couple of months to notice a drop in sperm cell counts. However, even the mature sperm cells that are exposed to chemotherapy or radiation may have damaged DNA as a result and may not be able to function normally.
Once a patient has become azoospermic following cancer treatment, it may be possible for him to become fertile again. However, the process of sperm cell formation must start again from the very beginning, as if the patient were going through puberty. The testicle stem cells (or germ stem cells) must resume function and repopulate the testicle, so that sperm cell formation can resume. The process may take up to several years to complete.
Certain treatment regimes and stem cell or marrow transplant are likely to cause permanent infertility.
Chemotherapy may also cause a number of other sexual side effects that may interfere with the ability to produce children. This could include decreased desire for sex, an inability to have or keep an erection and difficulty ejaculating.
Infertility is a common side effect of treatment for leukemia, lymphoma and myeloma. While it may be impossible to prevent fertility problems while still maintaining an effective cancer treatment regime, there may be some options for male cancer patients to preserve their fertility. Please discuss these options with your healthcare team as soon as possible following your diagnosis.
Sources
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.
