Men's fertility and chemotherapy

This page is about the effects that chemotherapy can have on fertility in men. It includes

How chemotherapy can affect your fertility
Sperm banking
Checking your fertility

Not all drugs affect your fertility. But some can

Reduce the number of sperm you produce
Affect the sperm's ability to fertilise a female egg

If this happens it may be temporary or permanent and mean that you will no longer be able to father children. Whether it is temporary or permanent depends on the drugs you have, the doses you have and your age. Permanent infertility is more likely if you have higher doses of the drugs.

It is important to use contraception throughout your treatment as it is not advisable to father a child while you are having chemotherapy – the drugs could harm the baby.

Some chemotherapy drugs can affect the nerves in the genital area and may cause temporary problems with being able to have or maintain an erection. These usually disappear gradually once the treatment is finished.

Usually you can still get an erection and have an orgasm as you did before your treatment. Chemotherapy drugs don't normally have any permanent effect on your sexual performance or your enjoyment of sex.

If your chemotherapy treatment is likely to cause infertility, you may want to store some of your sperm before you start your treatment. The sperm can be stored for many years in a sperm bank. It can then be used later as part of fertility treatment. If this is possible in your case, you will need to produce several sperm samples over a few weeks. These are frozen and stored. You will usually be tested first for infections such as hepatitis and HIV. Sperm banking is not always available on the NHS and there may be a charge for this.

If you and your partner later want a baby, the samples are thawed and used to inseminate your partner. Inseminate means putting your sperm into your partner to start a pregnancy. Many people have had healthy babies after fertility treatment following chemotherapy.

It is important to talk to your doctor about the risk of infertility before you start your chemotherapy treatment. You can then make decisions about whether to use a sperm bank. Teenage boys are also able to store sperm. Some men with certain types of cancer may have very low sperm counts due to their cancer and then it may not be possible to store sperm. Sometimes your doctor may want to start your treatment very quickly. In this case it may not be possible to store sperm or only to store one sample

If chemotherapy has made you infertile it can be difficult to predict whether your sperm production will go back to normal or not

Some men stay infertile
Others find their sperm returns to normal and their fertility comes back

It can take a few months or sometimes years for fertility to return to normal. Your doctor can do regular sperm counts for you when your treatment is over.