What is infertility?
Infertility is the inability to father a child.
What can affect fertility?
Unfortunately some cancer treatments, such as chemotherapy and radiotherapy can cause infertility. This may be temporary but in some cases it can be permanent. How your fertility is affected depends on the type of chemotherapy drugs that you have, or the part of your body that is treated with radiotherapy.
Does all chemotherapy or radiotherapy treatment affect fertility?
Some chemotherapy drugs will have very little effect on male fertility. Others may reduce the number and quality of the sperm you produce. This may be temporary or permanent.
Radiotherapy should not affect your fertility unless you have treatment to your testicles or the whole of your body (known as total body irradiation).
I have been told that my cancer treatment may make me infertile - will this be permanent?
Every man is different - some men’s sperm production will return to normal quickly, while for others it may take several years. There is a possibility that your ability to produce normal sperm may never recover enough to allow you to father a child naturally.
The amount and quality of sperm produced varies for different men. Even before the start of treatment some men may have problems producing normal sperm. Some cancers can also make this more likely. Your doctor will explain in more detail how your treatment will affect your fertility.
When will this be discussed with me?
Your doctor will discuss the risk of infertility with you before you start your treatment. If you have a partner, they will probably wish to join you for this discussion so that you are both aware of all the facts and can talk about your feelings and options for the future.
If infertility is likely to be permanent, you may be offered the opportunity to collect sperm for storage in a sperm bank before you start treatment. This is discussed later in the leaflet.
Will I still be able to have sex?
You should still be able to get an erection and have an orgasm, as you did before you started your treatment. You will still produce semen when you orgasm, but it may be reduced and not contain enough sperm for you to father a child naturally.
Should I use contraception while I’m having chemotherapy or radiotherapy?
You should always use contraception during your treatment to reduce the risk of conceiving a baby with damaged sperm. While you are having chemotherapy you should use condoms, as there is a small risk of the chemotherapy drugs being transferred to your partner in sperm or seminal fluid.
If the condom breaks or splits during sex, your partner should take emergency contraception, or the ‘morning-after pill’. This is available from Family Planning clinics, GPs or pharmacies.
How long should I continue to use contraception after my chemotherapy has finished?
Your sperm may not develop normally for about a year after you finish treatment. You should continue to use contraception during this period as it is not advisable to father a child.
How will I know if I’m infertile after treatment?
A semen analysis test can be arranged when you have completed your treatment. This test will check the production and quality of sperm in your semen. It will only give an idea of how well your sperm has recovered and it is not a guarantee of fertility or infertility.
Sperm banking
If you have not completed your family before you need to start tratment, you may be able to bank some of your sperm for later use. Sperm banking is available at IVF Wales at the University Hospital of Wales.
If this is possible, you will be asked to produce several sperm samples over a few days. They will be frozen and stored so that they can be used later to try to fertilise an egg from your partner.
How will my sample be collected?
This is done in a private collection room at IVF Wales. You ejaculate (have a climax) through masturbation. Your wife or partner may also come into the room with you.
Ideally you should not masturbate or make love for up to three days before each sample is produced so that more sperm can be collected. However, if your treatment needs to start quickly, you may be asked to give samples on consecutive days.
Why do I need a blood test for HIV, hepatitis B and hepatitis C?
It is routine practice for all men storing sperm to have blood tests for HIV and hepatitis. This is because these viruses can be transferred through semen. If you think that you have a high risk of being HIV positive, counseling can be arranged before the test.
Will sperm banking delay my treatment?
There is usually time to arrange sperm banking before the start of treatment, unless your doctor feels that it is important to start your treatment straightaway. If this is the case, or if you are very unwell, sperm banking may not be possible or there may only be enough time to collect and store a single sample.
If my treatment has started, can I still bank sperm?
No. Once your chemotherapy or radiotherapy has started any sperm you produce may be damaged by the treatment. This sperm would not be suitable for use in the future.
How many samples need to be stored?
Ideally, three samples are stored. There is not always enough time to collect three samples, but one sample may still be enough to use in the future.
How long can sperm be stored?
Sperm can be stored until you reach the age of 55.
Is it safe to use stored sperm to start a family?
Yes. Studies looking at children born using stored sperm have shown that there is no difference in their health compared to children conceived naturally.
What happens to my sperm sample if I die?
If you are in a stable relationship, you can agree that your partner can use your sperm after your death. You will be named as the father on the birth certificate.
If you do not agree to a named partner using your sperm after your death then your sperm will be removed from storage and destroyed.
What happens if I no longer wish my sperm to be stored?
If you regain your fertility after treatment, or no longer wish to store your sperm, you can contact IVF Wales and they will remove your sperm from storage and destroy it.
What happens if I move house?
If you move house you will need to contact IVF Wales on 029 2074 3047 to give them your new details.
Is there anything else I have to do?
You will need to complete a consent form. This is a legal form that allows IVF Wales to store your sperm. It also asks you what you wish to happen to your sperm after your death.
Contact telephone numbers
This leaflet raises some complicated issues. If you would like to discuss anything further or would like more information please contact one of the phone numbers below.
Specialist nurse in male cancers - 029 2061 5888 ext 6991
Information and Support Radiographers - 029 2061 5888 ext 6428
IVF Wales - 029 2074 3047
Macmillan - 0808 808 0000
www.macmillan.org.uk
Tenovus freephone helpline - 0808 808 1010
www.tenovus.com
This information leaflet was written by health professionals. It has been approved by doctors, nurses and patients.