Fertility treatment for men
There are different kinds of fertility treatment. The type you’re advised to have will depend on the way that cancer or treatment has affected your fertility.
If your sperm count is low
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If you’ve had cancer treatment and are still producing sperm but only in very low numbers, there may still be a chance of making your partner pregnant naturally. However, if you’ve been advised to have fertility treatment, you may be offered in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). These are sometimes called ‘test-tube baby’ treatments, but the baby is not made in a test-tube.
In vitro fertilisation (IVF)
Your partner is given a course of drugs to make her ovaries produce more mature eggs than normal. A small operation is then done to collect the eggs. A sedative is given to relax her, and a fine needle is put through the top of her vagina and into an ovary. The eggs can be collected through the needle.
The eggs are then fertilised in the laboratory by mixing them with a preparation of your sperm. Usually only one of the resulting embryos is then placed in your partner’s womb, a few days later, in the hope that this will lead to a pregnancy. A pregnancy test can be done about 12 days later. If your partner is pregnant, this can be seen on an ultrasound scan after about three weeks.
Intracytoplasmic sperm injection (ICSI)
In ICSI, the eggs are collected in the same way as for IVF, but they are fertilised by injecting the eggs directly with a single sperm. The rest of the process is the same as for IVF.
If you have sperm stored and they’re healthier than the sperm you’re currently producing, your doctors may suggest that you use the stored sperm for IVF or ICSI instead.
If you aren’t producing sperm
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If you’re not producing any sperm at all, you won’t be able to have a child unless you stored your sperm before your cancer treatment. You may, however, be able to use donated sperm.
Using frozen sperm
Frozen sperm can sometimes be used for a fairly simple fertility treatment if:
the sperm are healthy when they are thawed
you have a lot of sperm stored
there are no concerns about your partner’s fertility.
Your partner will have blood tests and ultrasound scans to monitor her menstrual cycle and show when she is about to release an egg. When the egg is about to be released from the ovary, your stored sperm are thawed and placed around the neck of her womb, or directly into her womb. If this process is carefully timed, it has a good chance of success and is the closest option to becoming pregnant naturally. This process is called intrauterine insemination (IUI).
Using donated sperm
If you don’t have any frozen sperm, the only fertility treatment available is to use sperm that have been donated by someone else.
People who donate sperm are carefully chosen. Their general health is checked and they’re offered counselling to make sure they understand exactly what it means to help infertile people in this way. Occasionally it might be possible to use known donors or surrogates - such as brothers or friends - but, as with all decisions about surrogacy or donated sperm or eggs, it requires careful thought and counselling for everyone involved.
If you decide to have fertility treatment using sperm from a donor, you will also be offered counselling and information about what it involves. There can often be a waiting list for this treatment.
If your partner is fertile, treatment using donated sperm (that have been frozen and stored) is usually medically straightforward. The process is the same as the process described for couples using frozen sperm.
This type of fertility treatment has good success rates and is called donor insemination (DI). If it doesn’t result in a pregnancy, your partner may be prescribed hormones to make the ovaries release more eggs. This process is called stimulated intrauterine insemination. The donated sperm are put directly into your partner’s womb. Treatments using donated sperm can also be carried out using the IVF procedure.
If you can’t have sexual intercourse
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Some people can’t have sexual intercourse because of physical changes caused by the cancer or its treatment. In this situation, it may still be possible for the doctors to take your sperm and use them in IVF or ICSI treatment. This can allow you to have your own biological children. Where this isn’t possible, you may like to think about using donated sperm or surrogacy.
You can watch a video of Charlie explaining his experience of fertility treatment. This information is written for people of all ages, not just teens and young adults.