Cancer - Male Infertility Diagnosis

Men with previous malignancies requiring chemotherapy are at risk for low or absent sperm counts. Chemotherapy usually affects cells that are dividing quickly and that’s exactly what sperm cells do.

Therefore, sperm cells are very vulnerable to many types of chemotherapy. This vulnerability is highest after the onset of puberty and in adulthood. If a man has received chemotherapy as a child, he may or may not still be able to produce sperm. If sperm counts are very low, intrauterine insemination or in vitro fertility will be the solution. If sperm is absent from the semen, then sperm retrieval surgery may allow sperm to be found in about 50 percent of cases. If an adolescent or adult male is faced with having to receive chemotherapy, he should freeze and store sperm for future use as a safeguard against the sterilizing potential of chemotherapy.

Banked sperm can be used for either intrauterine insemination or in vitro fertility and its usable lifespan is not limited. Frozen sperm can be used successfully many years later. Because it can be used up quickly, it is recommended that a man freeze several specimens. Once a man has finished chemotherapy, he should wait at least a year to conceive with his own ejaculated sperm to allow for any abnormal impacts the chemotherapy may have had on the sperm to subside so as to protect his offspring from adverse effects. It is not known exactly when or if there would be any lingering effects of the chemotherapy but most experts agree a one-year waiting period is acceptable. In cases where men receive radiation therapy to the genital area, sperm freezing and storing is again recommended and in these cases a two-year waiting period is recommended prior to initiating a pregnancy with regularly ejaculated sperm so as to limit the effects the radiation might have on sperm.

Testis cancer causes male infertility in one out of three men with testis cancer. Sometimes a low sperm count is the first clue a patient has that he may have testis cancer, so a thorough examination is recommended for any male in an infertile couple. Once a diagnosis of testis cancer is made, chemotherapy may be part of the treatment plan. Chemotherapy will cause about one in three men who are treated to become infertile. As with other chemotherapy patients, either intrauterine insemination, in vitro fertility, or sperm retrieval surgery with in vitro fertility will be the solution. Sometimes surgery of the lymph nodes will be recommended, and in some cases this surgery can impair the man’s ability to ejaculate. The treatment for this condition is sperm retrieval surgery an in vitro fertility or electro-ejaculation, which is described in the section entitled Abnormal Ejaculation.

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