Men’s options before cancer treatment

Here we discuss ways a man can preserve his fertility before starting cancer treatment. It’s ideal to discuss the options with your cancer or fertility specialist at this time. See the Making decisions for more on this.

Some choices, such as sperm banking and radiation shielding, are well-established ways to preserve fertility. Others, such as testicular sperm extraction, are still being researched and may not be available to all men. The different choices depend on the type of cancer you have and your personal preferences.

Ask your cancer specialist how long you have to consider your options. In many cases, you can wait a week or two before starting cancer treatment. Fertility treatments carry some risks and your doctor should discuss these before you go ahead. Keep in mind that no method works all of the time.

If you didn’t have an opportunity to discuss your options before cancer treatment, you can still consider your fertility later. Your choices after treatment will depend on whether you are able to produce sperm. See the Men’s options after cancer treatment for detailed information.

  — Zac

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Sperm banking or sperm freezing (cryopreservation)

What is this?

The freezing and storing of sperm.

Sperm banking is one of the easiest and most effective methods of preserving a man’s fertility.

When is it used?

To delay the decision about having children, if you’re not yet sure what you want.

Samples can be stored for years, or even decades. Check the time limits with the fertility clinic, pay any annual fees, and keep your contact details up to date.

Once you are ready to start a family, the frozen sperm is sent to your fertility specialist.

How does it work?

The procedure is performed in hospital or in a sperm bank facility (often known as an andrology unit). Samples are collected in a private room where you can masturbate or have a partner sexually stimulate you, and you then ejaculate into a jar.

Sometimes you may need to visit the clinic more than once to ensure an adequate amount of semen is collected.

Other considerations

If you live near a sperm banking facility, you may be able to collect a sample at
home and deliver it to the laboratory within the hour. Sperm must be kept at room temperature during this time.

If you are unable to get an erection or produce a sample through masturbation,
other options include testicular biopsy or testicular stimulation techniques. You may be able to collect semen during sex using a special silicone condom.

You may feel nervous and embarrassed going to a sperm bank, or worry about
achieving orgasm and ejaculating. The medical staff are used to these situations.
You can also bring someone with you, if you would like.

Radiation shielding

What is this? Protecting the testicles from external radiation therapy with a shield.
When is it used? If the testicles are close to where external radiation therapy is directed (but are not the target of the radiation), they can be protected from the radiation beams.
How does it work? Protective lead coverings called shields are used.
Other considerations This technique does not guarantee that radiation will not affect the testicles, but it does provide some level of protection.

Testicular sperm extraction (TESE)

What is this? A method of looking for sperm inside the testicular tissue. Also called surgical sperm retrieval.
When is it used? If you don’t or are unable to ejaculate, or the semen ejaculated doesn’t contain sperm.
How does it work? You will be given a general anaesthetic and a fine needle will be inserted into the epididymis or testicle to find and extract sperm. This is called testicular aspiration. Collected sperm is frozen and can later be used to fertilise eggs during IVF.

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This information was last reviewed in May 2018
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