Fertility after cancer treatment

After cancer treatment, your doctor can explain if and when your fertility is likely to recover.

If your fertility returns you may decide to try to have a baby naturally. Your doctor may advise you to wait for a time to make sure you are producing healthy sperm again.

If cancer treatment has damaged your fertility or made it difficult to have sex, you and your partner may decide to have fertility treatment. You may be able to use your own frozen or fresh sperm. If cancer treatment has made you permanently infertile and you haven’t stored any sperm, you may be able to use donated sperm. Everyone who donates sperm is carefully selected.

Fertility treatments include

  • directly inserting sperm into a woman’s womb
  • mixing sperm with eggs in a laboratory
  • injecting one sperm directly into an egg.

The NHS will usually pay for some fertility treatment. Ask your doctor for more information.

Many children have been born using fertility treatments. But fertility treatment doesn’t always result in a pregnancy. Your fertility doctor will discuss any possible risks with you.

Making plans

It can take time to move forward with life after cancer treatment. The decision to try for a baby is a big one for anyone to make. If you’ve had cancer, this brings its own extra challenges. If you are considering this, you can talk to your cancer doctor or nurse again. You may have worries and questions about fertility that didn’t seem important before cancer treatment.

If there is a chance that your fertility will recover after cancer treatment, you may decide to wait and try to have a baby naturally. Your cancer doctor can give more information about when your fertility might come back and what to expect. Depending on the cancer treatment, they may advise you to wait for some time before trying to have a baby. This is to make sure you are producing healthy sperm again.

Often it’s difficult to know exactly how or when your fertility will recover. Fertility testing can check the quality and amount of sperm you’re producing.

If your fertility doesn’t come back after cancer treatment, you may be able to use your own frozen sperm to help you have a baby. If you didn’t store sperm before cancer treatment, you may decide to use donor sperm.

Some men still produce sperm but the cancer treatment has caused problems with erections or ejaculation. It may still be possible to collect sperm. This can then be used with fertility treatments to help you have a baby.

Surgery or radiotherapy to the pituitary gland can stop sperm being produced. In this case, you can have hormone injections (gonadotrophin replacement injections) to start sperm production again.

Some people worry about passing cancer or cancer genes onto their children. Cancer can’t be passed from a parent to child. A small number of people have an inherited cancer gene that makes their risk of getting cancer higher. But this is rare and most cancers are not caused by inherited cancer genes. Talk to your doctor if you’re worried about the risk of cancer running in your family.

We have more information about cancer genes and planning a family that may be useful.

You may decide not to try for a baby at all. Or some people choose to adopt or foster a child. Whatever you decide, support is available. Talking to other people can also be helpful while you’re thinking through your options. There’s no right or wrong way to feel. Everyone is different.

It’s very nice to know that there is sperm frozen if I am infertile down the line. It was a good thing to do and a good back up even though I think the chance of me being infertile is pretty low.

Anthony


Fertility testing

After treatment you can have your sperm tested to find out if you’ve started to produce healthy sperm again. Being able to get an erection and ejaculate does not always mean that you are fertile. Sometimes the semen may not have any sperm in it.

Your cancer doctor or GP can arrange a fertility test for you. This test is available free on the NHS. You may pay a fee to have it done privately. If needed, the test can be repeated.


Fertility treatment

If cancer treatment has damaged your fertility or made it difficult to have sex, you and your partner may decide to have fertility treatment.

The NHS will usually pay for a number of fertility treatments, depending on your situation. There are rules about fertility treatment in the NHS. If you decide to have fertility treatment, it is important to remember that these rules will apply to your partner as well as to you. Fertility treatment rules and funding vary across the UK. Your local fertility doctor will be able to give you information about this.

Many children have been born using fertility treatments. There don’t appear to be any increased long-term health risks to the child. Your fertility doctor can give you more information about any possible risks with these treatments.

Fertility treatment doesn’t always result in a pregnancy. Your fertility expert will discuss this with you. But many people have had babies as a result of collecting and storing sperm and using fertility treatments.


Fertility techniques

After cancer treatment you may decide to use your frozen sperm to try and start a family. Your sperm will be carefully thawed in a laboratory when it’s needed.

If you didn’t have sperm collected before cancer treatment, it may still be possible to use your fresh sperm. Even if you are only producing very low numbers of sperm, sometimes this can be collected and used. Your fertility doctor will be able to talk to you about your options.

Your sperm can be directly inserted into a woman’s womb. This is called intra-uterine or artificial insemination. Or the doctors may use a process called in vitro fertilisation (IVF). During IVF, eggs are mixed with the sperm in a laboratory to see if an egg fertilises and becomes an embryo. The embryo is then transferred into the womb.

Sometimes a technique known as intra-cytoplasmic sperm injection (ICSI) is used. This is done in the laboratory. Under a microscope, a fine needle is used to inject a single sperm directly into the egg. If an egg is fertilised, the embryo can later be placed in the womb to see if a pregnancy develops.

ICSI may be used when the number of sperm is low. For example:

  • if you had sperm collected surgically by PESA or TESE
  • if the freezing process has reduced the quality of your sperm
  • if you’re still fertile but cancer treatment has reduced the number or quality of your sperm.


Using donated sperm

If cancer treatment has made you permanently infertile and you have not had sperm stored, you and your partner may think about using donated sperm. Choosing to use donated sperm can be a difficult decision. The fertility doctor will offer you and your partner counselling about this. It may not be acceptable for some people for religious reasons. If you are worried or unsure about this, speak to your religious advisor.

There’s a shortage of sperm donors in the UK so you may have to wait to find a suitable one. Some people decide to use sperm from sperm banks in other countries.

Treatment with donor sperm may not be funded by the NHS in some areas of the UK. The staff at your fertility clinic will know more and can talk to you about this.

Everyone who donates sperm is carefully selected:

  • Usually a donor is matched as closely as possible for eye and hair colour, physical build and ethnic origin.
  • The donor has to be fit and healthy with no medical problems.
  • The donor is tested for infectious diseases such as HIV, hepatitis B and C and some genetic conditions.


If your pituitary gland is affected

The pituitary gland controls hormones called gonadotrophins. These stimulate the testicles to produce testosterone and sperm. Cancer treatment to the pituitary gland may reduce your testosterone levels and sperm production. Low testosterone levels can make it difficult to get an erection and can leave you with a lower sex drive. It can also cause other problems such as thinning of the bones (osteoporosis), tiredness and a low mood.

You can take testosterone replacement therapy to reduce some of these problems. It can be given for life. But this doesn’t stimulate the testicles to make sperm so you won’t be able to conceive a child while you’re taking it.

If you want to have children, it’s possible to have gonadotrophin replacement injections instead.

These injections stimulate the testicles to start producing sperm again. You have the injections regularly until you’ve managed to conceive naturally or collected sperm samples to use with fertility treatments. It can take several months of injections to start sperm production. Usually you have injections for up to two years. After that you start taking testosterone replacement therapy again.

Back to Fertility in men

What is fertility?

Fertility in men means being able to make a woman pregnant. Cancer and cancer treatment can affect this.

Getting support

You may find it helpful to talk to someone about any fertility worries.