Male options before cancer treatment

In this section we discuss ways you can preserve your fertility before starting cancer treatment. It’s ideal to discuss the options with your cancer or fertility specialist at this time. For more on this, see Making decisions.

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Discussing your options

Some choices, such as sperm banking and radiation shielding, are well-established ways to preserve fertility. Surgically extracting sperm from the testicles is another way to store sperm for later use. The option that is right for you depends 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 starting cancer treatment, you can still consider your fertility later. Your choices after treatment will depend on whether you are able to produce sperm. For more on this, see Male options after cancer treatment.

All my life I had wanted to be a father. I didn’t want cancer to ruin my chances, so I stored my sperm before treatment started. I think of this as a bit of an insurance policy.

Zac

Preserving fertility in males

Sperm banking or sperm freezing (cryopreservation)

What this is
  • collecting, freezing and storing sperm
  • this is the standard way of preserving fertility in males
When this is used
  • when you want to store sperm for the future
  • samples can be stored for up to 20 years
  • legal limits on how long sperm can be stored are different in each state and territory
  • your fertility clinic can advise about time limits and the cost of storage
How this works
  • the procedure is performed in hospital or in a sperm bank facility (also called an andrology unit)
  • samples are collected in a private room where you can masturbate or have a partner sexually stimulate you and then ejaculate into a jar
  • it’s recommended that you provide 2–3 samples; you may need to visit the clinic more than once to ensure an adequate amount of semen is collected
  • sperm is then frozen until needed
  • when you are ready to have a child, the frozen sperm is thawed and used to fertilise an egg using IVF
Other considerations
  • if you collect semen at home, you must keep the sample close to body temperature and get it to the sperm bank facility within an hour
  • if you want to collect semen during sex, you must use a special condom you can get from the sperm bank facility
  • if you are unable to ejaculate, there are medical ways to encourage ejaculation
  • if you are unable to produce a sample of semen, sperm may be collected using testicular sperm extraction
  • sperm can also be collected from men with retrograde ejaculation
  • 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

Radiation shielding

What this is
  • protecting the testicles from external beam radiation therapy with a shield
When this is used
  • if the testicles are close to where radiation beams are directed (but are not the target of the radiation), they can be protected from the radiation beams
How this works
  • 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 this is
  • a method of looking for sperm inside the testicular tissue
  • also called surgical sperm retrieval
When this is used
  • when you can’t ejaculate
  • when there is not enough sperm in the semen sample
How this works
  • under anaesthetic, a fine needle is inserted into the epididymis or testicle to find and extract sperm; this is called testicular aspiration
  • if no sperm is found, your specialist may do an open biopsy to retrieve a larger tissue sample
  • collected sperm is frozen and can later be used to fertilise eggs during IVF
Other considerations
  • rarely, no sperm is found in the testicular tissue

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Key resource

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Fertility and Cancer

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This information was last reviewed in May 2020. View who reviewed this content.

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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