Overview: Cancer treatment can impair men’s sexual function and fertility. As many as 1 in 8 men will be diagnosed with prostate cancer in his lifetime, which often requires surgery. Cancer treatments, such as radiation and prostate removal, commonly leave men infertile. Fortunately, there are several options for men to improve their odds of fertility following cancer treatment.
In addition to worries about erectile dysfunction after prostate surgery, men of reproductive age who survive cancer and its treatment often are left infertile. Fortunately, there are alternate means of conception that can allow men to father children.
This article explores the effects that cancer and its treatment can have on male sexual function and possible fertility solutions.
How Will Cancer Impact My Sexual Health?
Cancer and its resulting treatment can have a significant impact on men’s overall health and sexual function. The stress alone of a cancer diagnosis and undergoing cancer treatment has been shown to negatively affect sexual health and intimacy for both men and women. Undergoing cancer treatment can also disrupt your normal reproductive function, causing erectile dysfunction or infertility.
But a cancer diagnosis does not have to mean the end of a fulfilling sex life or loss of fertility. Thanks to modern treatments, men can still get erections and reach orgasm following cancer treatment. And if you’re worried about infertility, know that you have options for future conception.
What is Male Infertility?
Male infertility describes the situation when men are unable to impregnate a woman. Fertility is dependent on reproductive organs working “normally” as well as other factors, such as frequency and timing of unprotected sex. Male infertility can be caused by low sperm count, illness, injury, chronic medical conditions, certain medications or medical treatments, or the removal of the prostate.
Doctors typically deem someone infertile after 12 consecutive months of trying to conceive. Male infertility can be evaluated by a medical professional by testing a semen sample to determine sperm production and motility.
How Will Cancer Impact My Fertility?
Men often become infertile after undergoing radiation therapy or prostate surgery. Any major change in organ function or reproductive health can cause men to become infertile. Radiation therapy, chemotherapy, and prostate removal can all dramatically alter the reproductive organs and their function.
Your risk of infertility following cancer treatment may vary depending on:
- Your age and stage of development. Undergoing treatment early in life can affect your long-term fertility outcomes.
- Your treatment plan. Both the type and the dose of treatment provided will impact the risk of infertility. For example, you may undergo chemotherapy, radiation, hormone therapy, targeted therapy, stem cell transplant, immunotherapy, or another form of treatment. Each of these treatment plans will affect fertility differently.
- Your specific surgery. The type of surgery you have depends on your diagnosis and treatment plan. Different types of surgeries affect fertility in different ways.
Which Cancer Treatments Cause Male Infertility?
Some cancer treatments are more likely than others to impact your fertility. You should speak with your medical provider regarding your risk of infertility following surgery or other forms of treatment. You should also discuss fertility planning prior to undergoing treatment.
Common types of cancer treatments that cause male infertility include:
- Testicular surgery. The removal of one or more testicles is called an orchiectomy. If you have one remaining healthy testicle, you should still be able to produce sperm and reproduce. However, some men do experience issues with their remaining testicle that can result in infertility.
- Prostate surgery. Prostatectomy is the most common cause of male infertility after cancer treatment. This is because during a prostatectomy, both the prostate and seminal vesicles are removed. The prostate and seminal vesicles are essential to semen production, which is what transports sperm through the urethra and out of the penis. Your testicles still make sperm, but without semen, you cannot expel it from your body.
- Radiation therapy. Radiation therapy also disrupts reproductive function and commonly causes male infertility. This is because radiation can damage both the seminal vesicles and sperm. Damage and disruption to sperm production, storage, and transport have critical consequences for fertility.
- Chemotherapy. Chemotherapy can affect long-term fertility. Your risk after chemotherapy is dependent upon the extent of your treatment.
- Bladder surgery. With bladder cancer, the bladder may need to be removed during a radical cystectomy. During this surgery, the bladder, prostate, and seminal vesicles are removed. Much like with a radical prostatectomy, your body no longer has the ability to transport sperm from the testicles and through the urethra, resulting in infertility.
- Other surgeries. Surgeries for colorectal cancer and other cancers can also impair fertility. This can be due to organ removal or nerve damage.
- Other therapies. Hormone treatment and immunotherapies can negatively affect sperm production and result in infertility. Again, the risk is dependent upon the extent of your treatment.
What Are My Fertility Options After Cancer Treatment?
Thanks to advances in modern medicine and technology, men have a wide variety of options for fertility following cancer treatment. The best option for you will depend on the treatment you underwent, the extent of your fertility challenges, and if you planned ahead to bank sperm prior to your cancer treatment.
Current fertility solutions for men include:
- Sperm analysis and fertility counseling. If you are still able to produce sperm and ejaculate, you may benefit from sperm analysis 12 or more months following your cancer treatment. A provider can assess the quality and motility of your sperm and counsel you on options for conception.
- In vitro fertilization (IVF). If you are still able to produce sperm and ejaculate but your sperm count is low, you may choose to conceive via IVF. This process involves fertilizing an egg outside the body (in vitro) and transferring the fertilized egg to a uterus.
- Sperm banking. Using a sperm bank to store your healthy sperm is the most reliable option for conceiving after prostate surgery and other intensive cancer treatments. A sperm bank will store your semen by freezing it in liquid nitrogen. When you want to retrieve your sample, it will be thawed, and up to 50 percent of the sperm is likely to be usable for artificial insemination.
- Sperm extraction. If you are still able to produce healthy sperm, then you may be able to use sperm extraction to improve your fertility odds after surgery. With this procedure, sperm is removed from testicular tissue and injected into an ovum (egg).
- Treating retrograde (dry) ejaculation. In cases of infertility caused by retrograde ejaculation (semen flowing backward into the bladder rather than forward and out of the body) after surgery, you can take medication to improve your condition or use sperm-banking services to retrieve sperm from a urine sample.
Your medical provider can help you to assess your options and navigate the process. Fertility treatments and sperm banking can be costly, so it is important that you weigh your options with a professional and make the best decision for you and your lifestyle.
Find Support at eDrugstore.com
Finding a support network throughout treatment and having a place to turn for answers to complex questions can make all the difference in improving sexual function and intimacy after a cancer diagnosis. No matter your situation, we have resources to support you at eDrugstore.com.
Learn more about cancer, sexual health, and erectile dysfunction by visiting our blog. And if you’re curious about prescription lifestyle medication, you can speak to a medical provider by calling 1-800-467-5146, or by visiting our erectile dysfunction page today!
Shelby is a public health professional with research and field experience in sexual and reproductive health. She holds a Master of Public Health (MPH) and is a Certified Health Education Specialist (CHES).