Men's options before cancer treatment

Sunday 1 June, 2014

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On this page: Sperm banking | Testicular sperm extraction | Radiation shielding | Key points

Related pages: Men's fertility and cancer treatment | Men's options after cancer treatment

This page has information about ways a man can preserve his fertility before starting cancer treatment. It’s ideal to discuss your options with your cancer or fertility specialist at this time. See talking about fertility for information.

Be sure to understand the risks of each fertility option and keep in mind that no method works 100% of the time.

If you didn’t have an opportunity to discuss your options before cancer treatment, you can still consider it later. Your choices after treatment will depend on if you are able to produce sperm.

Sperm banking

Sperm banking is one of the easiest and most effective methods of preserving fertility. It also allows you to delay the decision about having children, if you’re not yet sure what you want.

  • Sperm banking is done in hospital or a sperm bank facility (often known as an andrology unit).
  • You’ll be taken to a private room where you will need to get an erection and reach orgasm by masturbating or having a partner sexually stimulate you. You will be discouraged from using lubricant, as it may damage sperm and make it difficult to freeze.
  • It is important to try to collect all of the semen in the sterile jar you are given. The first portion often contains most of the sperm.
  • You may be required to attend the clinic more than once to ensure an adequate amount is collected.

You may wonder about collecting sperm at home. Some men near a sperm banking facility may be able to collect the sample in private and deliver it to the laboratory within the hour. Sperm must be kept at room temperature during this time.

It’s generally not recommended to collect sperm during sex because bacteria can mix with the sample and make it unusable. However, in some situations, you can collect the semen using a special silicone condom. Your fertility specialist will talk to you about this option if you are unable produce a sperm sample through masturbation.

The sample will be frozen (cryopreserved). It’s possible to store the sample for a long time. However, it’s important to ask about any time limits, ensure annual fees are paid and check that your contact details are up to date.

Once you are ready to start a family, the frozen sperm is sent to your fertility specialist.

Your feelings about sperm banking

It is not unusual to feel nervous before going to a sperm bank. You may feel embarrassed about announcing to staff why you are there, or worry about being unable to achieve orgasm and ejaculate.

The medical staff are professionals and are used to dealing with these situations. They will do their best to support you, and they will also allow you to bring someone with you, if you want.

Harry’s story

"When I was 25, I’d been feeling quite ill – I had back pain, night sweats and weight loss. I was diagnosed with advanced Hodgkin lymphoma.

"The doctors recommended I bank sperm immediately, because fertility would be an issue post-treatment. Fertility wasn’t my main concern. However, my partner – now wife – and I were together at that point, so we knew it could be an issue for us down the track.

"My chemotherapy regime was aggressive, but the cancer went into remission. The chemo permanently reduced my testosterone levels. I’ve taken supplements for years, and I will be on them for quite some time. However, the supplements didn’t restore my fertility.

"Years later, my wife and I tried artificial insemination using my banked sperm. When that didn’t work, we tried IVF. The first cycle was unsuccessful. We told ourselves if a second IVF cycle didn’t work, we were going to give up for a while. Being told we were pregnant was one of the happiest days of our lives.

"We now have a beautiful child, and we’ve decided to stick with what we’ve got. We don’t want to do more IVF – it’s financially and emotionally draining. Even though we have no intention of using it, my remaining sperm is still stored. We were advised to keep it until my wife reaches a certain age – I guess in case we change our minds.

"At times, I’ve felt responsible for everything. My wife is a healthy woman and probably capable of conceiving a pregnancy naturally, but she had to go through IVF. Our son asks why he can’t have a sibling. But it’s something we’ve accepted. We feel blessed now with one child – the result was worth everything we went through."

Tell your cancer story.

Testicular sperm extraction

This procedure (also called surgical sperm retrieval) may be used if you don’t ejaculate or the semen ejaculated doesn’t contain sperm. Specialists use it to look for hidden sperm inside the testicular tissue.

During the procedure, you will be given an anaesthetic and a fine needle is inserted into the epididymis or testicle to find and extract sperm. This is called epididymal aspiration. Sperm collected is usually frozen for future use during IVF.

Radiation shielding

If the testes are close to where external radiotherapy is directed (but they are not the target of the radiation), they can be protected from the radiation beams. This is done using protective lead coverings called shields.

This technique does not guarantee that radiation will not affect the testes, but it does provide some level of protection.

"All my life I had wanted to be a father. I didn’t want cancer to ruin my chances, so I stored my sperm before treatment started. I think of this as a bit of an insurance policy." – Zac

Key points

  • Sperm banking is the easiest and most effective method. A sample is frozen for later use.
  • If you have radiotherapy, your doctor can shield the testicles so that the radiation does not harm them.
  • Testicular sperm extraction may look for hidden sperm inside the testicular tissue.

Reviewers: Prof Martha Hickey, Head of Obstetrics and Gynaecology, University of Melbourne, VIC; Franca Agresta, Clinical Research Manager, Melbourne IVF, VIC; Alyssa White, National Publications Project Manager, Cancer Council NSW; and Georgia Mills, Cancer Survivor.
Updated: 01 Jun, 2014