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Fertility - having children after testicular cancer

Men and woman discussing testicular cancer

This page tells you about fertility after treatment for testicular cancer. There is information about

 

A quick guide to what's on this page

Fertility – having children after testicular cancer

The good news is that most men who have testicular cancer who were fertile before being diagnosed are able to father children after treatment. The biggest risk to fertility is chemotherapy but even then about 7 out of 10 men (70%) are able to father children.

Surgery

Surgery to remove the lymph glands in your abdomen can affect your fertility. The operation can cause retrograde ejaculation. Your semen and sperm go back into your bladder instead of coming out of your penis. This has no effect on your ability to have an erection or an orgasm, although your orgasms will be dry.

Chemotherapy

Chemotherapy causes temporary infertility in most men with testicular cancer. In some men fertility may not recover, particularly those who have had very high doses of chemotherapy.

Sperm banking

Because treatments may reduce fertility, your doctor will offer you the chance of sperm banking before starting treatment if you are likely to want to have children in the future.

 

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How common infertility is after testicular cancer

The good news is that most men with testicular cancer who were fertile before being diagnosed are able to father children after treatment. A survey of men treated between 1982 and 1992 showed that 77 out of every 100 (77%) were able to father a child. Another 5 out of 100 (5%) did so after having fertility treatment. So that means that more than 8 out of 10 men (80%) who wanted to father a child after testicular cancer were able to do so. The biggest risk to fertility is chemotherapy but even then about 7 out of 10 (70%) are able to father children.

If your treatment for testicular cancer does cause permanent infertility, you'll no longer be able to father a child. This can be very hard to accept if you were hoping to have children. You and your partner should discuss this possibility with your doctor before you start treatment. You should be offered the opportunity of sperm banking before starting treatment if you are concerned about your future fertility.

 

Surgery and fertility

Sometimes the lymph glands in your abdomen need to be taken out by surgery, especially if they are still enlarged after radiotherapy or chemotherapy. This can affect your fertility because the operation can cause retrograde ejaculation. New techniques in surgery are helping to reduce this problem.

Remember that although this surgery may mean you cannot father a child, it has no physical effect on your ability to have an erection or an orgasm.

 

Chemotherapy and fertility

Chemotherapy causes temporary infertility in most men with testicular cancer. In some men, fertility may not recover, particularly in those who have had very high doses of chemotherapy.

Talk to your doctor if you are worried about whether chemotherapy will affect your fertility. You can have tests to see if your fertility has gone back to normal and your doctor can talk this over with you.

Some men with testicular cancer have a low sperm count before they start treatment. In these men successful treatment with chemotherapy can make their sperm count go back to a more normal level.

 

Sperm banking

Usually your doctor will offer you the chance to save some semen before treatment. If your sperm is suitable and you want to store some for the future, you need to give 2 or 3 semen samples over a period of a few days. You usually do this at a fertility clinic. The samples are frozen and stored by the hospital. The samples can be kept frozen until you’re 55. If you and your partner want to have a child in the future, the samples are thawed and used with fertility treatments.

You will have counselling at the fertility clinic before you have sperm banking. You will also need to sign a consent form that states how you want your sperm to be used. You will have blood tests to check for any illnesses or infections, such as HIV or hepatitis.

The NHS often pays for sperm banking for men with cancer, but in some hospitals you may have to pay for it yourself.

If the cancer has spread and you need to start your chemotherapy right away, your doctor may advise against sperm banking because it could delay the start of your cancer treatment.

If your sperm count is low

These days you may be able to benefit from sperm banking even if your sperm count is low. It is quite common for men with testicular cancer to have a low sperm count. Doctors and researchers have developed a technique that can help, called micro injection of sperm. This involves choosing good quality sperm from a sample even if the sample is poor quality with a low sperm count. The good sperm are then frozen like a normal sample. When you want to use the sperm, the sample is thawed and the surviving sperm are used to fertilise your partner's egg.

The fertilised egg is then implanted in the womb to grow naturally. This is the same as the test tube baby technique. Doctors can't guarantee that it will work for you. Some sperm die when the sample is thawed. And the test tube technique doesn't always work first time.

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Updated: 18 September 2014