Learn about male options after cancer treatment. Understand sperm assessment, collection methods, and fertility options available to you.
Learn more about:
- Overview
- Checking fertility after treatment
- Natural conception
- Intrauterine insemination (IUI)
- In-vitro fertilisation (IVF)
- Donor sperm
- Finding information about the donor
Overview
It’s a good idea to see a fertility specialist about 6–12 months after cancer treatment for review. This is important to check your hormones, as well as to check future fertility. While there is currently no reliable way of checking how treatment has affected your fertility, these tests provide your fertility specialist or reproductive endocrinologist with some information.
Depending on the results of these tests, your options include:
- conceiving naturally
- intrauterine insemination or IUI
- artificial insemination or IVF using your own sperm frozen before treatment or fresh sperm collected after treatment
- testicular sperm extraction, if you can’t ejaculate normally or there is no sperm in the semen
- banking sperm after treatment ends, if you are still fertile
- using donor sperm.
Checking fertility after treatment
After treatment, you may be able to have an erection and ejaculate, but this doesn’t necessarily mean you are fertile. If treatment has permanently affected your ability to produce sperm and have erections, you will no longer be able to conceive naturally.
Fertility testing
Before trying to conceive, you may want to do some tests to see how your fertility has been affected. These tests include a semen analysis (sperm count) and blood tests that measure levels of testosterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH). These can be arranged by your fertility specialist or reproductive endocrinologist. The results will help the specialist recommend the best options for having a child after cancer treatment.
If you stored sperm in a sperm bank before cancer treatment, your doctor can compare this sample to your sperm sample after treatment.
Natural conception
You may be able to get your partner pregnant naturally after finishing cancer treatment. This will only be possible if your semen production returns to normal and you are making healthy, active sperm. As fertility declines with age, it will also depend on the age of you and your partner.
Your medical team will do tests both to check your general health and assess your fertility. Depending on the treatment you’ve had, they may advise you to wait 6 months to 2 years before trying to conceive. Discuss the timing and contraception options with your specialist.
The pituitary gland makes hormones that tell the testicles to make sperm. If cancer treatment has damaged the pituitary gland, you may be able to have medical treatment to trigger the production of sperm. This is called sperm induction.
Intrauterine insemination (IUI)
Also called artificial insemination, this technique places the sperm directly into the uterus. IUI increases the chance that the sperm will fertilise an egg. The sperm may be fresh or it may have been frozen. The sample is washed and faster-moving sperm are separated from slower sperm.
Insemination is usually done in a fertility clinic. Once your partner is ovulating, the sperm are inserted into their uterus using a small, soft tube (catheter). This takes only a few minutes and may cause some mild discomfort to your partner. You should know in a few weeks whether pregnancy has occurred.
In-vitro fertilisation (IVF)
IVF uses either sperm collected and frozen before treatment, or fresh sperm to fertilise an egg outside of the body. Intracytoplasmic sperm injection (ICSI) is a specialised type of IVF in which a single, good-quality sperm is injected into an egg.
Learn about the general IVF process and see a diagram of how IVF works, or ask your fertility specialist to explain the process in more detail.
Donor sperm
If you are infertile after cancer treatment, you could consider using donor sperm.
In most cases, sperm are donated by a family member or friend. Your fertility clinic may have access to donor sperm, but there is usually a waiting list. You may be able to advertise for your own donor. It’s possible to use sperm from overseas, but there are strict rules about importing donor sperm into Australia.
About sperm donors
Sperm donors have voluntarily contributed sperm to a fertility clinic. They are not paid for their donation, but you can cover (reimburse) their travel or medical expenses.
All donors are required to:
- have blood tests for infectious diseases and screening for genetic conditions
- answer questions about their genetic and medical information
- have counselling.
Personal information is also collected, including details about ethnicity, education, hobbies, skills and occupation. Donors are usually between 21 and 45 years old.
Screening and preparation
Sperm samples are screened for genetic diseases or abnormalities, sexually transmitted infections (STIs) and overall quality, then quarantined for several months. Before the sperm are cleared for use, the donor is checked again for infectious diseases.
Using donor sperm
When the sperm are ready to be used, insemination is usually done in a fertility clinic. The sample is thawed to room temperature and inserted directly into the uterus using IUI or combined with an egg using IVF. Identifying information about donors is available to donor-conceived people once they turn 18.
Finding information about the donor
In Australia, fertility clinics can only use sperm from donors who agree that people born from their donation can find out who they are. This means that the donor’s name, address and date of birth are recorded.
All donor-conceived people are entitled to get identifying information about the donor once they turn 18.
In some states, details about donors and their donor-conceived offspring are recorded on a central register.
Parents of donor-conceived children, and donor-conceived people who are over the age of 18, can apply for information about the donor through these registers. In other states and territories, people who want information about their donor can ask the clinic where they had treatment.
It is important to discuss possible issues for donor-conceived children with a fertility counsellor.
→ READ MORE: Preserving fertility in children and adolescents
We now have a beautiful child, and we’ve decided we don’t want to do more IVF – it’s financially and emotionally draining.
Harry
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More resources
Dr Sally Reid, Gynaecologist and Fertility Specialist, Obstetrics and Gynaecology (Adelaide) and Royal Adelaide Hospital, SA; Dr Sarah Ellis, Clinical Psychologist and Postdoctoral Research Fellow, Kids Cancer Centre, Sydney Children’s Hospital and UNSW, NSW; John Booth, Consumer; Hope Finlen, Haematology Nurse Consultant, Gold Coast University Hospital, QLD; Dr Michelle Harrison, Medical Oncologist – Gynaecological cancers, Chris O’Brien Lifehouse, NSW; Melissa Jones, Nurse Consultant, Youth Cancer Service SA/NT, Royal Adelaide Hospital, SA; Dr Violet Kieu, Clinical Director, Melbourne IVF and Fertility Specialist, The Royal Women’s Hospital, VIC; Prof Declan Murphy, Consultant Urologist, Director – Genitourinary Oncology, Peter MacCallum Cancer Centre and The University of Melbourne, VIC; Stephen Page, Family and Fertility Lawyer, and Legal Practice Director, Page Provan, QLD; Ann Retzlaff, 13 11 20 Consultant, Cancer Council WA; A/Prof Kate Stern AO, Fertility specialist, Gynaecologist and Reproductive Endocrinologist, Royal Women’s Hospital and Melbourne IVF, VIC; Georgia Webster, Consumer.
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