Fertility in young men
Cancer, and some cancer treatments, can have an effect on your fertility.
In men, fertility means being able to make a woman pregnant (father a child). The parts of your body that allow you to make babies are called your reproductive system.
A woman has eggs stored in her ovaries. A man makes sperm in his testicles. To have a child, your sperm needs to fertilise a woman’s egg.
In men, the testicles (balls) begin to make sperm from puberty onwards. This process is mainly controlled by a hormone called testosterone. Hormones are chemicals in the body that help control how the body works. 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.
Normally, you need to have sex to fertilise a woman’s egg. This involves getting an erection and coming (ejaculating) in a woman’s vagina. The semen, which contains sperm, is released and can fertilise an egg.
It might help to look at our information about the male sex organs.
Cancer treatments and fertility
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Your cancer doctor or specialist nurse will talk to you about your treatment options and their possible side effects. The main treatments are:
After diagnosis, it can feel like everything happens very quickly. It will take some time for you to adjust to the changes in your life. Try to talk to your family and friends about what’s happening to you and how you feel.
How treatment can affect fertility in men
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For men, cancer treatment may:
stop or slow down sperm production
cause problems with getting an erection and/or ejaculating normally.
Some cancer treatments may damage the cells that make sperm, meaning sperm can’t be produced. In this case, the body can still make semen, so you would still be able to ejaculate (come). But the semen would not be able to fertilise an egg to make a baby.
Testosterone is a hormone made in the testicles. It influences your desire to have sex (sex drive) and your ability to get an erection. Some treatments may reduce how much testosterone the testicles can make. This can lower your sex drive. It can also make it difficult or impossible to have an erection.
Surgery and radiotherapy
For an erection to happen, the nerves and blood vessels in the penis and testicles need to be working normally. But surgery or radiotherapy to this area can sometimes damage them.
A treatment called retroperitoneal lymph node dissection (RPLND) is sometimes used to treat testicular cancer. It involves removing lymph nodes in the tummy area (abdomen). This treatment can cause infertility, an inability to ejaculate or an inability to get an erection. If you need this type of surgery, your doctor and specialist nurse will discuss this with you in detail.
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.
They said not to be stupid if I was going to have sex. You know, still use protection. Don't just think because there's a possibility it might destroy your sperm, that it's definitely going to destroy it totally.
Throughout your treatment and for up to a year afterwards, you should use a barrier form of contraception (such as condoms or the cap). This is because some side effects of cancer treatment, such as sickness and diarrhoea, can make other contraceptives (like the pill) less effective.
It’s important that you don’t become pregnant or father a child while you are having treatment. Cancer treatments may damage sperm, which could affect a baby that is conceived at this time. Cancer treatments may also harm a developing baby.
It can be confusing if you’re being told to use contraception while your doctors are also talking about how treatment might affect your fertility. Even though your doctors will talk to you about your fertility and ways of preserving it, sometimes this is just a precaution. The doctors can’t know how the cancer or its treatment will affect your fertility. It is possible that you will remain fertile throughout treatment.