Page last updated: October 2025
The information on this webpage was adapted from Fertility and Cancer: A guide for people with cancer, their families and friends (2025 edition). This webpage was last updated in October 2025.
Expert content reviewers:
This information was developed with the help of a range of health professionals and people affected by side effects to the mouth area:
- Dr Sally Reid, Gynaecologist and Fertility Specialist, Obstetrics and Gynaecology (Adelaide) and Royal Adelaide Hospital, SA
- Dr Sarah Ellis, Clinical Psychologist and Postdoctoral Research Fellow, Kids Cancer Centre, Sydney Children’s Hospital and UNSW, NSW
- John Booth, Consumer
- Hope Finlen, Haematology Nurse Consultant, Gold Coast University Hospital, QLD
- Dr Michelle Harrison, Medical Oncologist – Gynaecological cancers, Chris O’Brien Lifehouse, NSW
- Melissa Jones, Nurse Consultant, Youth Cancer Service SA/NT, Royal Adelaide Hospital, SA
- Dr Violet Kieu, Clinical Director, Melbourne IVF and Fertility Specialist, The Royal Women’s Hospital, VIC
- Prof Declan Murphy, Consultant Urologist, Director – Genitourinary Oncology, Peter MacCallum Cancer Centre and The University of Melbourne, VIC
- Stephen Page, Family and Fertility Lawyer, and Legal Practice Director, Page Provan, QLD
- Ann Retzlaff, 13 11 20 Consultant, Cancer Council WA
- A/Prof Kate Stern AO, Fertility specialist, Gynaecologist and Reproductive Endocrinologist, Royal Women’s Hospital and Melbourne IVF, VIC
- Georgia Webster, Consumer
Male options before cancer treatment
This section outlines ways you can preserve your fertility before starting cancer treatment. It’s ideal to discuss the options with your cancer or fertility specialist as soon as possible.
Sperm banking (freezing or cryopreservation) and radiation shielding are well-established ways to preserve fertility. Surgically extracting sperm from the testicles is another way to store sperm for later use.
The best option for you depends on the type of cancer you have and your personal preferences. Keep in mind that no method works all the time. Fertility treatments carry risks and your doctor should discuss these with you before you go home.
If you didn’t have an opportunity to discuss your options before starting cancer treatment, you can still consider your fertility later. Your choices after treatment will depend on whether you are able to produce sperm.
“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
Ways to preserve fertility in males
Banking sperm or freezing sperm (cryopreservation)
- What this is – collecting, freezing and storing sperm. This is the standard way of preserving fertility in males.
- When this is used – when you want to store sperm for the future – samples can be stored for up to 20 years, depending on the laws of each state and territory.
- How this works – the procedure is performed in hospital or in a sperm bank facility (also called an andrology unit). Samples are collected in a private room where you can masturbate or have a partner stimulate you, and then ejaculate into a jar. It’s recommended that you provide 2–3 samples – you may need to visit the clinic more than once to ensure an adequate amount of semen is collected. The sperm is then frozen until needed, and when you are ready to have a child, the frozen sperm is thawed and used to fertilise an egg using IVF.
- What to consider – if you collect semen at home, you must keep the sample close to body temperature and get it to the sperm bank facility within an hour. If you want to collect semen during sex, you must use a special condom from the sperm bank facility. If you are unable to ejaculate, there are medical ways to encourage ejaculation. If you are unable to produce a sample of semen, sperm may be collected using testicular sperm extraction.
You may feel nervous and embarrassed going to a sperm bank, or worry whether you will be able to ejaculate. The medical staff are used to these situations and you can also bring someone with you.
Radiation shielding
- What this is – protecting the testicles from external beam radiation therapy with a shield.
- When this is used – if the testicles are close to where radiation beams are directed (but are not the target of the radiation), they can be protected from the radiation beams.
- How this works – protective lead coverings called shields are used.
- What to consider – this technique does not guarantee that radiation will not affect the testicles, but it does provide some level of protection.
Testicular sperm extraction (TESE)
- What this is – a way of looking for sperm inside the testicular tissue. It is also called surgical sperm retrieval.
- When this is used – when you can’t ejaculate, when there is not enough sperm in the semen sample, or to collect sperm from men with retrograde ejaculation.
- How this works – under anaesthetic, a fine needle is inserted into the epididymis or testicle to find and extract sperm (testicular aspiration). If no sperm is found, your specialist may do an open biopsy to retrieve a larger tissue sample. The collected sperm is frozen and can later be used to fertilise eggs during IVF.
- What to consider – rarely, no sperm is found in the testicular tissue.
“I was diagnosed with advanced Hodgkin lymphoma when I was 25. I banked sperm the week before chemotherapy started. My chemotherapy regimen 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 some time. However, they didn’t restore my fertility.” Harry
Male options after cancer treatment
It’s a good idea to see a fertility specialist about 6–12 months after cancer treatment for review. This is important to check your hormones, as well as to check future fertility.
While there is currently no reliable way of checking how treatment has affected your fertility, these tests provide your fertility specialist or reproductive endocrinologist with some information. Depending on the results of these tests, your options include:
- conceiving naturally
- intrauterine insemination or IUI, or IVF, using your own sperm frozen before treatment or fresh sperm collected after treatment
- testicular sperm extraction, if you can’t ejaculate normally or there is no sperm in the semen
- banking sperm after treatment ends, if you are still fertile, and
- using donor sperm.
If you stored sperm in a sperm bank before cancer treatment, your doctor can compare this sample to your sperm sample after treatment.
Checking fertility after treatment
After treatment, you may be able to have an erection and ejaculate, but this doesn’t necessarily mean you are fertile.
If treatment has permanently affected your ability to produce sperm and have erections, you will no longer be able to conceive naturally.
Before trying to conceive, you may want to do some tests to see how your fertility has been affected.
These tests include a semen analysis (sperm count) and blood tests that measure levels of testosterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH).
These can be arranged by your fertility specialist or reproductive endocrinologist. The results will help the specialist recommend the best options for having a child after cancer treatment.
Natural conception
You may be able to get your partner pregnant naturally after finishing cancer treatment. This will only be possible if your semen production returns to normal and you are making healthy, active sperm.
As fertility declines with age, it will also depend on the age of you and your partner. Your medical team will do tests both to check your general health and assess your fertility.
Depending on the treatment you’ve had, they may advise you to wait six months to two years before trying to conceive. Discuss the timing and contraception options with your specialist.
The pituitary gland makes hormones that tell the testicles to make sperm. If cancer treatment has damaged the pituitary gland, you may be able to have medical treatment to trigger the production of sperm. This is called sperm induction.
Intrauterine insemination (IUI)
Also called artificial insemination, this technique places the sperm directly into the uterus. IUI increases the chance that the sperm will fertilise an egg.
The sperm may be fresh or it may have been frozen. The sample is washed and faster-moving sperm are separated from slower sperm.
Insemination is usually done in a fertility clinic. Once your partner is ovulating, the sperm are inserted into their uterus using a small, soft tube (catheter).
This takes only a few minutes and may cause some mild discomfort to your partner. You should know in a few weeks whether pregnancy has occurred.
In-vitro fertilisation (IVF)
IVF uses either sperm collected and frozen before treatment, or fresh sperm to fertilise an egg outside of the body.
Intracytoplasmic sperm injection (ICSI) is a specialised type of IVF in which a single, goodquality sperm is injected into an egg. Ask your fertility specialist to explain the process in detail.
“We now have a beautiful child, and we’ve decided we don’t want to do more IVF – it’s financially and emotionally draining.” Harry
Donor sperm
If you are infertile after cancer treatment, you could consider using donor sperm. In most cases, sperm are donated by a family member or friend.
Your fertility clinic may have access to donor sperm, but there is usually a waiting list. You may be able to advertise for your own donor.
It’s possible to use sperm from overseas, but there are strict rules about importing donor sperm into Australia.
Sperm donors have voluntarily contributed sperm to a fertility clinic. They are not paid for their donation, but you can cover (reimburse) their travel or medical expenses. All donors are required to:
- have blood tests for infectious diseases and screening for genetic conditions
- answer questions about their genetic and medical information
- have counselling.
Personal information is also collected, including details about ethnicity, education, hobbies, skills and occupation. Donors are usually between 21 and 45 years old.
Sperm samples are screened for genetic diseases or abnormalities, sexually transmitted infections (STIs) and overall quality, then quarantined for several months.
Before the sperm are cleared for use, the donor is checked again for infectious diseases.
When the sperm are ready to be used, insemination is usually done in a fertility clinic. The sample is thawed to room temperature and inserted directly into the uterus using IUI or combined with an egg using IVF.
Identifying information about donors is available to donor-conceived people once they turn 18.
Finding information about the donor
In Australia, fertility clinics can only use eggs, sperm and embryos from donors who agree (consent) that people born from their donation can find out who they are.
This means that the donor’s name, address and date of birth are recorded.
People who opt to use donor sperm, must undergo a discussion with a fertility counsellor about how they will approach this topic with their donor-conceived children.
Once donor-conceived people turn 18, they are allowed to access identifying information about the donor.
In some states, a central register is used to record details about donors and their donorconceived offspring.
In states with a central register, parents of donor-conceived children, and donor-conceived people who are over the age of 18 can apply for information about the donor through the register.
In states and territories where there is no central register, people who want information about their donor can ask the clinic where the fertility treatment took place.
It is important to discuss possible issues for donor-conceived children with a fertility counsellor.