Fertility - having children after testicular cancer

The good news is that the vast majority of men who were fertile before being diagnosed are able to father children after having treatment for testicular cancer. A survey of men treated between 1982 and 1992 showed that 77 out of every 100 (77%) were able to father a child and another 5 out of 100 (5%) did so after having fertility treatment. So that's over 8 out of 10 (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 may be offered the opportunity of sperm banking before starting treatment if you are concerned about your future 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 - 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. It doesn't cause impotence.

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.

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 returned 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 cause their sperm count to return to a more normal level.

You may be able to save some semen before treatment. If your sperm is suitable and you want to store some for the future, you need to produce a number of semen samples over a period of a few days. These are frozen and stored for some time by the hospital. When you want to father a child, the semen is thawed and your sperm used to artificially inseminate your partner.

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. A technique that can help, called micro injection of sperm, has been developed. This involves selecting good quality sperm from a sample even if the sample is poor quality with a low sperm count. The good sperm can then be frozen like a normal sample. When the sperm are needed, the sample is thawed and the surviving sperm 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 but with your individually selected sperm. Doctors cannot guarantee that it will work for you. Some sperm die when the sample is thawed. And the test tube technique does not always work first time.

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

Discuss sperm banking with your doctor before your treatment starts. If you are interested, you'll have tests to check your sperm count.