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Men's options before cancer treatment

This section has information about ways a man can preserve his fertility before starting cancer treatment. It's ideal to discuss the options with your cancer or fertility specialist at this time. See Making decisions.

Some choices, such as sperm banking and radiation shielding, are well-established ways to preserve fertility. Others, such as testicular sperm extraction, are still being researched and may not be available to all men. The different choices depend on the type of cancer you have and your personal preferences.

Ask your cancer specialist how long you have to consider your options. In many cases, you can wait a week or two before starting cancer treatment. Fertility treatments carry some risks and your doctor should discuss these before you go ahead. Keep in mind that no method works all of the time.

If you didn't have an opportunity to discuss your options before cancer treatment, you can still consider your fertility later. Your choices after treatment will depend on whether you are able to produce sperm. See Men's options after cancer treatment.

"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

Options for preserving fertility in men

Sperm banking or sperm freezing (cryopreservation)

What this is

The freezing and storing of sperm.

Sperm banking is one of the easiest and most effective methods of preserving a man's fertility.

When this is used

To delay the decision about having children, if you're not yet sure what you want.

Samples can be stored for years, or even decades. Check the time limits with the fertility clinic, pay any annual fees, and keep your contact details up to date.

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

How this works

The procedure is performed in hospital or in a sperm bank facility (often known as an andrology unit).

Samples are collected in a private room where you can masturbate or have a partner sexually stimulate you, and you then ejaculate into a jar.

Sometimes you may need to visit the clinic more than once to ensure an adequate amount of semen is collected.

Other considerations

If you live near a sperm banking facility, you may be able to collect a sample at home and deliver it to the laboratory within the hour. Sperm must be kept at room temperature during this time.

If you are unable to get an erection or produce a sample through masturbation, other options include testicular biopsy or testicular stimulation techniques. You may be able to collect semen during sex using a special silicone condom.

You may feel nervous and embarrassed going to a sperm bank, or worry about achieving orgasm and ejaculating. The medical staff are used to these situations. You can also bring someone with you, if you would like.

Radiation shielding

What this is

Protecting the testicles from external radiation therapy with a shield.

When this is used

If the testicles are close to where external radiation therapy is 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.

Other considerations

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 method of looking for sperm inside the testicular tissue. Also called surgical sperm retrieval.

When this is used

If you don't or are unable to ejaculate, or the semen ejaculated doesn't contain sperm.

How this works

You will be given a general anaesthetic and a fine needle will be inserted into the epididymis or testicle to find and extract sperm. This is called testicular aspiration. Collected sperm is frozen and can later be used to fertilise eggs during IVF.

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.

"I banked sperm the week before chemotherapy even 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 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. We found the process emotionally and financially draining. 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 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 brother or sister. 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.

Expert content reviewers:

Dr Yasmin Jayasinghe, Paediatric Gynaecologist, Royal Children's Hospital Melbourne, Co-chair Fertility Preservation Taskforce, Melbourne, and Senior Lecturer, Department of Obstetrics and Gynaecology, University of Melbourne, VIC; Dr Peter Downie, Head, Paediatric Haematology-Oncology and Director, Children's Cancer Centre, Monash Children's Hospital, and Director, Victorian Paediatric Integrated Cancer Service, VIC; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland; Aaron Lewis, Consumer; Pampa Ray, Consumer; Dr Sally Reid, Gynaecologist, Fertility SA and Advanced Gynaecological Surgery Centre, Visiting Consultant, Women's and Children's Hospital, and Clinical Senior Lecturer, School of Paediatrics and Reproductive Health, The University of Adelaide, SA; A/Prof Kate Stern, Head, Fertility Preservation Service, The Royal Women's Hospital and Melbourne IVF and Head, Endocrine/Metabolic Clinic, Royal Women's Hospital, and Co-chair, AYA cancer fertility preservation guidance working group, VIC.

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