Surgery

Surgery that removes part or all of the reproductive organs to treat cancer can cause infertility.

Removal of one or both ovaries (oophorectomy)

If one ovary is removed, the other ovary should continue to release eggs and produce hormones. If you still have a uterus, you may still have periods and be able to become pregnant. If both ovaries are removed (bilateral oophorectomy), you will experience immediate medically induced menopause. You will no longer have periods or be able to become pregnant naturally.

Removal of the uterus and cervix (hysterectomy)

This type of surgery may be used to treat cancer of the cervix, ovary, uterus and, sometimes, cancer of the vagina. After a hysterectomy, there is nowhere for a baby to develop and your periods will stop. Sometimes the ovaries will also be removed. If your ovaries are left in place and continue to work, you may be able to fertilise your eggs through IVF and use a surrogate to carry the pregnancy.

Removal of the testicles (orchidectomy)

Treatment for testicular cancer usually involves removing one testicle. If you have had one testicle removed, you can go on to have children naturally. However, men with testicular cancer have lower fertility rates than the general population. The urologist may advise you to store sperm at a sperm banking facility before the surgery, just in case you have fertility problems in the future.

In some rare cases, both testicles are removed (bilateral orchidectomy). This causes permanent infertility because you will no longer produce sperm. You will still be able to get an erection.

Removal of the prostate (prostatectomy)

Surgery for prostate cancer usually involves removing the prostate and seminal vesicles, and sealing the tubes from the testicles (vas deferens). This causes permanent infertility because you will not be able to ejaculate semen during orgasm. This is known as a dry orgasm.

Removal of the penis (penectomy)

Part or all of the penis may be removed to treat cancer of the penis. The part of the penis that remains may still get erect with arousal and may be long enough for penetration. It is sometimes possible to have a penis reconstructed after surgery, but this is still considered experimental and would require another major operation.

Removal of the bladder, prostate or one or both testicles

This may damage the nerves used for getting and keeping an erection (called erectile dysfunction or impotence). Erectile dysfunction may last for a short time or be permanent.

It may be possible for the surgeon to use a nerve-sparing technique to protect the nerves that control erections. This works best for younger men who had strong erections before the surgery. However, problems with erections are common even with nerve-sparing surgery.

→ READ MORE: The impact of hormone therapy on fertility

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