Fertility in young men

If might help to see our information about the male sex organs|. From puberty onwards, the testicles (‘balls’) begin to produce millions of sperm. The process of producing sperm is controlled by hormones. The sperm are stored in the testicles until they’re released from the penis during ejaculation (when you ‘come’). The sperm are released in a fluid called semen.

Some cancer treatments| may damage the cells that produce sperm, so that no sperm are produced. It’s still possible to produce a normal amount of semen from the penis, even if it doesn’t contain any sperm. So some young men are still able to ejaculate even if the semen can’t fertilise an egg to make a baby.

The male hormone testosterone influences sex drive and affects the ability to get an erection (‘hard-on’). A different hormone stimulates the testicles to produce testosterone.

Some cancer treatments may reduce the production of testosterone by the testicles, which may mean that you have a low sex drive or that it’s difficult or impossible to have an erection.  

For a man to make a woman pregnant, sexual intercourse has to take place where the man has an erection and ejaculates (releases) sperm into the vagina. If an egg is in the fallopian tube at the right time of the menstrual cycle, it can be fertilised by a sperm. The fertilised egg then buries itself in the lining of the womb and can grow to form a foetus and then become a baby.

For an erection to happen, the nerves and blood vessels in the penis and testicles need to be working normally. Surgery or radiotherapy to the pelvic area can sometimes damage these nerves and blood vessels.

Cancer treatments and fertility Back to top

The main treatments for cancer are chemotherapy, radiotherapy, surgery, stem cell transplants and hormonal therapy.

For men, cancer treatments can affect fertility in different ways. Some stop or slow down sperm production, while others may cause problems with getting an erection and/or ejaculating normally. If low testosterone levels are contributing to infertility, you can have testosterone replacement therapy. There are also drugs and different techniques| that can be used to help you get and keep an erection.

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We have more information about how cancer treatments can affect your fertility|, which has been written for men of all ages, not specifically for teenagers and young adults.

Contraception Back to top

During and sometimes after treatment you’ll be advised to use contraception if you’re having sex, even though you and your doctor may not know whether any damage has been done to your fertility. This is so you don’t accidentally make a woman pregnant while you’re still recovering from the effects of the treatment. Barrier methods of contraception (for example condoms) can also reduce the risk of sexually transmitted infections. Your doctor or nurse can discuss this with you.