After cancer treatment, your medical team will analyse a sample of your semen to assess how many sperm you are making, how healthy they look and how well they move (motility). For more on this, see Assessing fertility after treatment.
Learn more about:
- Natural conception
- Banking sperm
- Intrauterine insemination (IUI)
- In-vitro fertilisation (IVF)
- Donor sperm
- Finding information about the donor
- Using donor sperm
- Surrogacy
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. If treatment has permanently affected your ability to produce sperm and have erections, you will no longer be able to conceive naturally.
Your medical team will do tests to assess your fertility and check your general health. Depending on the treatment you’ve had, they may advise you to wait six months to two years before trying to conceive. Discuss the timing and suitable contraception with your specialist.
The pituitary gland produces hormones that tell the testicles to produce 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.
If you are producing sperm, but you can’t ejaculate normally or there is no sperm in the semen, you may be offered testicular sperm extraction.
Intrauterine insemination (IUI)
Also called artificial insemination, this technique increases the chance that the sperm will fertilise an egg by placing the sperm directly into the uterus. The sperm may be fresh or it may have been frozen before treatment.
To be used for IUI, sperm samples must be of reasonable quality. The sample is washed and the faster-moving sperm are separated from the slower sperm.
Insemination is usually done in a fertility clinic. Once your partner is ovulating, the sperm are inserted into her uterus through the cervix 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 fertilisation took place.
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 more about how IVF works, or ask your fertility specialist to explain the process.
Donor sperm
If you are infertile after cancer treatment, using donor sperm is another way to become a parent. This is general information about donor sperm. Laws vary across Australia and may change. Talk to your fertility specialist to obtain specific advice about your situation.
You can ask a friend or family member to donate sperm, or you can get sperm from someone you don’t know. Fertility clinics in Australia may have access to donor sperm or you can advertise for your own donor.
There is a lot of demand for donor sperm so you may have to go on a waiting list. You may also be able to use sperm from overseas. However, there are strict rules about importing donor sperm into Australia.
Finding information about the donor
In Australia, 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, a central register is used to record details about donors and their donor-conceived offspring. 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.
Using donor sperm
Sperm donors have voluntarily contributed sperm to a fertility clinic. They are not paid for their donation, but may receive reimbursement for travel or medical expenses. The donors are usually aged 21–45.
All donors are required to complete health tests and go through a counselling process.
Personal information is also collected, including:
- 2–4 generations of family medical history
- details about their ethnicity, educational background, hobbies, skills and occupation
- health information, including infectious diseases status, drug use and blood type.
Samples are screened for genetic diseases or abnormalities, sexually transmitted infections (STIs) and overall quality, then quarantined for several months. Before the sperm is cleared for use, the donor is checked again for infectious diseases.
The sperm is frozen and stored in liquid nitrogen in individual containers. When the sperm is 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.
Some states and territories may have a limit on the number of people who can have children from the same sperm donor, including the donor’s partner. Talk to your fertility clinic for more information.
Listen to our podcast for people affected by cancer
Dr Ying Li, Gynaecologist and Fertility Specialist, RPA Fertility Unit, Royal Prince Alfred Hospital, NSW; Dr Antoinette Anazodo, Paediatric and Adolescent Oncologist, Sydney Children’s Hospital and Prince of Wales Hospital, NSW, and Lead Clinician for Youth Cancer NSW/ACT; Paul Baden, Consumer; Dawn Bedwell, 13 11 20 Consultant, Cancer Council Queensland; Maurice Edwards, Special Counsel, Watts McCray Lawyers, NSW; Helena Green, Clinical Sexologist and Counsellor, InSync for Life, WA; Dr Michelle Peate, Program Leader, Psychosocial Health and Wellbeing Research (emPoWeR) Unit, Department of Obstetrics and Gynaecology, Royal Women’s Hospital, The University of Melbourne, VIC; A/Prof Kate Stern, Gynaecologist and Reproductive Endocrinologist and Head, Fertility Preservation Service, Royal Women’s Hospital Melbourne, The University of Melbourne, VIC; Prof Jane Ussher, Chair, Women’s Health Psychology, Translational Health Resea ch Institute (THRI), School of Medicine, Western Sydney University, NSW; Renee Van Den Bosch, Consumer.
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