The Women's Center
Fertility & sperm preservation
A diagnosis of cancer at any age is a life-changing event. Cancer affects one in three women over their lifetime and two percent of women develop cancer before the age of 39. Even though modern cancer treatments - using chemotherapy and/or radiotherapy - have resulted in improved cure rates, these treatments are unfortunately not without significant consequences and side effects.
These consequences can be especially devastating for female patients of reproductive age. Cancer treatments are toxic to the ovary and can completely shut down ovarian function resulting in sterility. These patients, who are already being faced with significant challenges, are forced to make difficult decisions about their future reproductive choices much sooner than they expected.
At this point in time, therapy choices designed to preserve fertility for a patient undergoing cancer treatment are limited.
It is important to make decisions to pursue oocyte, zygote or embryo cryopreservation based on the advice of a fertility expert as well as your cancer specialist, as the time required for the IVF cycle consequently delays cancer treatment.
In 2008, there were 800,000 new cases of cancer diagnosed in American men. Cancer affects fifty percent of men over the course of their life, and ten percent of men will develop cancer before the age of sixty.
A male patient diagnosed with cancer will undoubtedly face many difficult decisions regarding his future health. One such decision that must be considered by a patient is in regard to the impact of his specific cancer and treatment options on future fertility choices.
Some types of cancer can directly decrease sperm number, while many cancer treatments can negatively affect male fertility. Cancers that can directly reduce sperm quality and number include testicular cancer and Hodgkin's lymphoma. Fifty percent of patients with testicular cancer and forty percent of patients with Hodgkin's disease will have low sperm counts at the time of diagnosis. The effect of cancer therapy on male fertility varies with the different cancer treatment options.
Chemotherapy does not only diminish sperm count, but it can also cause damage to the genetic makeup of sperm. Research has shown that this genetic damage can be repaired naturally, but this process can take up to two years. For this reason, it is recommended that patients who receive chemotherapy wait up to two years before fathering a child.
Radiation therapy has a much more controlled effect on fertility. If the radiation is not directed at the testicles, they can be shielded from the radiation. However, if a patient receives radiation to the testes or total body irradiation (in preparation for stem cell or bone marrow transplants), there is a very high probability that permanent azospermia (lack of sperm) will result.
Surgery can also negatively impact fertility. Surgery on the prostate, bladder, urethra, or colon may result in a retrograde ejaculation, which is a condition where the opening to the bladder does not close during ejaculation thus allowing the semen to enter the bladder instead of exiting the penis. Therefore, sperm will still be produced, but delivery of the sperm will be impaired resulting in functional infertility.
Although cancer and its treatments can have a destructive impact on male fertility, there are options available for cancer patients that can preserve fertility.
For patients interested in male fertility preservation, it is important to consult a fertility expert as well as one's cancer specialist in order to determine the best course of action for each patient.