Male Fertility and Chemotherapy

For couples undergoing chemotherapy, its effects on male fertility - as with its effects on female fertility - can be a major concern, particularly when other fertility problems are hindering their chances of getting pregnant.

Chemotherapy can have varying effects on a man's fertility; in some situations, the effects of this cancer treatment can lead to short-term infertility while in other cases, chemotherapy can result in long-term male fertility problems.

But what exactly are the effects of chemotherapy on male fertility and for how long does chemotherapy cause male fertility problems?

Chemotherapy: How Does it Affect Male Fertility?

The effects of chemotherapy on male fertility depend on the nature of treatment; namely, the type of drugs used. Also, some men remain infertile after cancer treatment while in others, their sperm production and quality levels return to normal after treatment. This improvement in sperm health can occur either a few months or years after treatment.

Some chemotherapy drugs can reduce sperm count, as well as the ability of sperm to fertilise the egg. In addition, chemotherapy can lead to problems with regard to sperm production and sperm ejaculation.

These effects may lead to temporary male fertility problems; however, it is important to remember that using contraception through the course of your chemotherapy treatment is essential because it is unsafe to get pregnant during chemotherapy, as drugs used during your cancer treatment can be harmful to a developing fetus.

Generally, if a man's fertility is going to improve after chemotherapy, a semen analysis will show healthy results within one to three years after chemotherapy treatment. However, it can take up to 9 years after chemotherapy for male fertility to improve.

Some chemotherapy drugs can have a negative effect on the nerves in the genital area, leading to temporary problems having and maintaining an erection. Generally, these problems gradually diminish once you have finished your treatment program.

It is also important to note that there is a natural decrease in male fertility in men aged 35 and over, as there is a link between male fertility and age.

Chemotherapy Treatments And Male Infertility
Certain types of chemotherapy drugs increase the risk of male infertility.

For example, high doses of Platinol (cisplatinum chemotherapy), Blenoxane and Bleomycin (bleomycin drugs) also increase a man's risk of long-term fertility problems.

Drugs that are most harmful to a man's fertility are alkylating chemotherapy drugs, including cyclophosphamide (Cytoxan), Dusulfan (myleran) and nitrogen mustard (Mustargen).

If a man receives 2 or more of these alkylating medications, has high doses of chemotherapy treatment or has a combination of chemotherapy and pelvic radiation, he is at an increased risk for infertility.

Also, radiation treatment, particularly that administered close to the testicles, increases the risk of infertility, as can the removal of one or both testicles.

In addition, certain types of cancer are linked to a particularly high risk of male infertility. Testicular cancer is one such cancer. This cancer reduces fertility in the 2 years prior to diagnosis; also, while only 1 to 3% of men have cancer in both testicles, the cancer-free testicle is often not healthy and as such unable to function properly.

Lymphoma and leukemia as well as Hodgkin's disease also increase a man's risk of infertility. These cancers reduce male fertility due to surgical treatment, as well as the physical distress and fever that they cause, leading to reduced sperm quality.

After Chemotherapy: Fertility Treatment Options
Talk to your doctor or fertility specialist about fertility treatment options prior to beginning chemotherapy.

If your doctor feels that long-term fertility problems are an issue for you, you can store sperm in a sperm bank prior to treatment. This can remain in storage for years. However, this process requires you to produce several sperm samples over the course of a few weeks. Sperm can later be used for assisted reproduction methods such as intrauterine insemination (IUI) and many couples have been able to conceive healthy babies in this manner.

However, a sperm bank might not be a practical option in the case that you need to start chemotherapy immediately; also, it may not be possible for men with very low sperm counts (oligospermia) or with an absence of sperm (azoospermia).

Other treatment options include testicular tissue freezing, in which tissue from the testes is extracted and then frozen for storage. It is later injected into the egg so that fertilisation can occur.

Once your cancer treatment is over, your doctor can conduct regular sperm counts. This can help you assess your fertility treatment options.

Symptoms of male infertility caused by chemotherapy are quite rare; one symptom that may be expressed is dry orgasm. Semen analysis is therefore an important diagnostic tool in assessing your fertility.

Learn more about preserving male fertility by visiting our forum.

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