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Men's fertility and chemotherapy

Some chemotherapy drugs can affect a man’s fertility. Talk to your doctor about your risk of infertility. They can tell you more about the possibility of storing sperm.

How chemotherapy affects fertility

Being infertile means you cannot have children.

Not all chemotherapy drugs affect your ability to father a child. But some drugs can:

  • reduce the number of sperm you produce
  • affect the sperm's ability to fertilise an egg

The infertility may be temporary or permanent. This depends on the drugs you have, the doses and your age. Permanent infertility is more likely if you have higher doses. 

Some chemotherapy drugs can affect the nerves in the genital area. This can make it difficult for you to get or maintain an erection. This is usually temporary and gets better gradually once the treatment has finished.

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

It is important to use contraception throughout your treatment. You should avoid fathering a child while you're having chemotherapy, as the drugs could harm the developing baby.

Sperm banking

Sperm banking means collecting and storing your sperm. You can then use the sperm later to father a child through fertility treatment. You need to store the sperm before you start treatment if there is a risk that treatment will affect your fertility.

It’s important to talk to your doctor about the risk of infertility before you start chemo. You can then make decisions about whether to use a sperm bank.

What happens

You will need to produce several samples of sperm over a few weeks. These are frozen and stored. You usually have tests first for infections such as hepatitis and HIV.

Using the sperm

A specialist clinic can store your sperm for many years.

When you and your partner want a baby, the clinic specialists thaw the samples. They then use them 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.

Possible problems

Sometimes it isn’t possible for you to bank sperm. This could be because the cancer has made your sperm count very low. Or sometimes your doctor may want to start treatment very quickly. In this case it may not be possible to store sperm or to store only one sample. 

Sperm banking is not always available on the NHS and there may be a charge.

Methods under development

Researchers are considering other ways men might be able to keep their fertility after chemotherapy. They are looking into:

  • using antioxidants, such as vitamin C, to protect the sperm
  • other agents that might help protect the sperm
  • removing testicular tissue before starting chemotherapy and freezing it

These methods are still in the early stage and need further research.

Checking your fertility.

If chemotherapy has made you infertile, it can be difficult to tell whether this is permanent or not. Some men stay infertile but 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. To check your fertility, your doctor can do regular sperm counts for you when your treatment is over.

Last reviewed: 
28 Feb 2018
  • Novel Drug Therapies for Fertility Preservation in Men Undergoing Chemotherapy: Clinical Relevance of Protector Agents ​

    A Rabaca and others

    Current Medicinal Chemistry 2015, Vol 22 (29), p. 3347-3369

  • New Promising Strategies in Oncofertility​

    J N Hudson and others
    Expert Review of Quality of Life in Cancer Care2017, Vol 2 (2), p. 67-78

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