Fertility options after cancer treatment

After cancer treatment, you may decide that you want to start a family. If you stored sperm before treatment, it may be used in the following ways:

  • Your sperm may be inserted in your partner’s womb.
  • Your sperm may be mixed with your partner’s eggs in a laboratory.
  • A single sperm may be injected into one of your partner’s eggs.

These techniques are thought to be safe and there don’t seem to be any risks to the child. However, there aren’t any guarantees that using these techniques will result in a pregnancy. You can talk to your fertility expert about this.

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 but there is a shortage of donors in the UK.

Some men are offered testosterone replacement therapy to help with problems getting an erection or having a reduced sex drive. This treatment can affect sperm production. If you want to have children in the future, speak to your doctor before starting this treatment.

After cancer treatment

If you decide you want to start a family, the stored sperm will be thawed in a laboratory. It can then be directly inserted into your partner’s womb (artificial insemination) or used for in vitro fertilisation (IVF). During IVF, your partner’s eggs are mixed with your sperm in a laboratory to see if an egg fertilises and becomes an embryo. The embryo is then transferred into your partner’s womb.

Sometimes a technique known as ICSI (intra-cytoplasmic sperm injection) may be used. This involves injecting a single sperm directly into an egg. This is helpful when:

  • cancer treatment has to start quickly
  • the cancer or its treatment has slowed sperm production
  • the sperm quality of the frozen samples is poor.

ICSI injection
ICSI injection

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Unfortunately, there aren’t any guarantees that stored sperm will be able to fertilise an egg and result in a pregnancy. Your fertility expert will discuss this with you before your sperm is stored. However, many couples have had babies as a result of storing sperm and fertility treatments.

Possible risks

Using frozen, stored sperm has been carried out for many years and there don’t appear to be any risks to the child. IVF has been used for over thirty years and appears to be safe. ICSI has been used for over twenty years and is generally considered a safe procedure. There may be a slightly higher risk of rare disorders in babies born from the treatment. Removing and using sperm directly from the testicle is a relatively new technique. Your fertility specialist can give you more information about any possible risks with these treatments.

Using donated sperm

If 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 clinic 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. It may not be funded by the NHS in some areas of the UK. The staff at the fertility clinic 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.

Testosterone replacement therapy

Some treatments to the pituitary gland or the testicles may reduce your testosterone levels. Testosterone levels can reduce slowly. This may lead to difficulties in getting an erection or a reduced sex drive, sometimes years after treatment. It can also cause other problems such as thinning of the bones (osteoporosis), tiredness and a low mood.

Testosterone replacement therapy will help to reduce these problems. It can be given for life. But it can affect your sperm production. If you want to have children, speak to your fertility doctor before starting this therapy.

Testosterone replacement is given as:

  • a patch that’s applied to the skin (transdermal)
  • a gel rubbed into your skin
  • an implant or injection into a muscle.

Your cancer specialist can give you more advice about this.

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Getting support

You might find it helpful to talk to family, friends or healthcare professionals about fertility.