You may not be thinking about becoming a father at this time; in fact, you may have no plans whatsoever for becoming a father. Regardless of how you currently feel, this is something you need to consider at this time. It is something that is simple to do and might save you significant mental and emotional anguish in the future.
You have been diagnosed with cancer and will be undergoing medical treatment that may affect your ability to father a child in the future. In order to ensure that you at least have the opportunity to father your own child, you now need to seriously consider sperm banking.
Why consider banking sperm before cancer treatment begins?
For the patient approaching cancer treatment, banking sperm is a way to put one significant issue out of your mind. Having even one sample of frozen sperm stored in the sperm bank, means the chance of having a biological child in the future, no matter what happens to your own fertility. With modern techniques of infertility treatment (in vitro fertilization using an injection of a single sperm cell into each egg), only a few live sperm cells need to survive the freezing and thawing process in order to create a pregnancy. If a man has good sperm quality and can freeze several semen samples (3 to 6), the couple may be able to achieve pregnancy using less extreme infertility treatments, such as artificial insemination. Although many men have abnormal sperm counts even before any cancer treatment is begun, it is still worthwhile to freeze the sperm, before the start of any treatment. Remember, you can always defrost in the future.
Sperm banking is a procedure whereby your sperm are collected before you undergo any treatment for your cancer. The sperm are frozen and kept in storage. Should you decide to father a child in the future and it is determined that your fertility has been affected by your cancer treatment, sperm banking will at least provide you with a chance to father your own children. It may turn out that your fertility is restored after your cancer treatment. While this would be ideal, there is no guarantee this will occur. You should consider the option of sperm banking and discuss any questions or concerns you have with your doctor. Your wife or partner should also be considered in the discussions. It is important that you carefully consider all of your options before undergoing any form of treatment for your cancer.
How cancer treatment affects sperm production
Radical Prostatectomy, External Radiation, Brachytherapy and Cryosurgery all will destroy some or all of the prostate. It will be virtually impossible for a prostate cancer patient to ejaculate sperm after any of these treatments.
For testicular and male breast cancer patients, chemotherapy may be a more critical problem. The testicles are the organs in a man's body that produce both testosterone (the male hormone) and sperm. Chemotherapy may not affect the production of testosterone, but studies have shown that chemotherapy can damage sperm production. There is a high probability that a man will experience at least some period of infertility following chemotherapy treatment; for this reason alone, men are encouraged to consider sperm banking before any treatment for cancer is started.
Some types of cancer treatments can harm a man's fertility, either temporarily or permanently. Many chemotherapy drugs will damage a man's ability to produce sperm. Chemotherapy typically kills all sperm forming cells resulting in a condition known as azoospermia - meaning no sperm are present in the ejaculate. There are different estimates as to if or when a man's sperm count will return to near normal levels following chemotherapy. In some situations, sperm production never returns. In other cases, sperm formation will begin again within about 1 to 4 years following treatment. However, there are situations where sperm counts will remain low as long as five years after treatment has stopped. Depending on the types of anti-cancer drugs given, the dose received and the individual's own unique recovery, fertility potential may return, or the man may produce only a few sperm which may not be enough to get a partner pregnant without medical assistance.
Permanent sterility is especially common in men who are given high doses of chemotherapy before a bone-marrow or stem-cell transplant. When radiation therapy is aimed at or near a man's testicles, it may also damage sperm production. Concern also exists about the potential for birth defects in the children of men receiving radiation treatment. Whole-body irradiation, used before transplants, can also cause infertility. After radiation therapy, a man may recover his fertility, depending on the dose of radiation received by his testicles. Radiation therapy can potentially damage sperm production and it may be necessary to wait 6 to 12 months or more before attempting to conceive. With some cancer surgeries, some men may have parts of their reproductive system, such as the prostate or a testicle removed, or experience damage to the nerves important for normal ejaculation. The potential complication of some surgeries, such as retroperitoneal lymph node dissection for testis cancer, is ejaculatory problems whereby the semen no longer comes out of the penis during ejaculation; instead it goes backward into the bladder, and is eliminated through urination or does not come out at all
What is sperm banking?
In order to bank sperm, you need to collect a sample of your semen. Usually this is done in a private collection room at the sperm bank. You ejaculate (have a climax) through your own self-stimulation. Your wife, husband or partner may also come into the room with you to help obtain a specimen. Most all sperm banks have yet to include gay friendly literature or video's in their collection rooms. If this is important to you, bring your own!
Once you give a semen sample, the lab will run tests to see how many sperm cells it contains (sperm count) and how many of them are swimming (motility or the measurement of the sperm cell's health). You will also be tested for sexually transmitted diseases, including hepatitis and HIV, since these viruses can be transmitted in the semen. The semen will be placed in a special container and frozen at extremely low temperatures. Semen samples can be safely stored in this frozen state for 10 years or longer. There has not been any evidence to suggest that pregnancies produced with frozen sperm have an increase for the chance of birth defects.
Sperm banking is an option you need to explore before any treatment for cancer is begun. Be sure to discuss this fully with your doctor and have all of your questions answered. Also, be sure to discover the costs of sperm banking, and how you might cover those costs.
last reviewed March 2007