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Chemotherapy saves lives every day, by killing rapidly dividing cells throughout the body.

This will hopefully mean that cancer cells are destroyed, but chemotherapy can also affect a man's fertility and not just if he is receiving treatment for testicular cancer, either. How likely are men to become infertile after chemotherapy, and what are the options for preserving fertility? 

Will chemotherapy make you infertile?

Infertility is a possible side effect of chemotherapy, which can attack your gametes right along with the cancer cells. The chemotherapy disrupts the production of sperm, and while this is often temporary it can also be permanent. The likeliness of suffering permanent infertility following chemotherapy treatment depends on a number of different factors.

Some chemotherapy drugs have a higher chance of causing infertility than others, and the dosage also matters higher dosages are more likely to do lasting damage to a man's reproductive system. The exact combination of chemotherapy drugs also matters. A man's age is also relevant. Younger men are more likely than older ones to recover their fertility after finishing chemotherapy treatment. In some cases, men will be given the chance to choose chemotherapy drugs that have a lower possibility of causing infertility.

In that case, the patient's cancer specialist will discuss this but men who would like to have children should always ask questions about the ways in which cancer treatment can impact fertility. Sperm production may be on hold for quite a while after finishing chemotherapy treatment it can take two or more years for fertility to come back, if it does. While a lack of sperm production doesn't, in itself, affect a man's sex life, there is something important to consider. Sperm may still be produced during the chemo itself, but conceiving a child during this period and up to a year later could affect the baby's health. Men who are undergoing chemotherapy should never try to conceive and should always choose a reliable birth control method. Condoms combined with the female contraceptive pill (for the man's partner, obviously) are a good option.

Other cancer treatments and infertility

Radiotherapy can stop sperm production just like chemotherapy, or might at least slow it down. It can also disrupt testosterone. Radiotherapy to the pelvis is more likely to result in infertility (permanent or temporary) than radiotherapy to other parts of the body, and radiotherapy to the testicles will lead to permanent infertility. Hormonal therapy, used in the treatment of prostate cancer and male breast cancer, can lead to erectile dysfunction and the loss of libido. Both can lead to fertility indirectly.

Though these problems can be temporary, they may also stick around. Finally, surgery associated with testicular cancer can lead to retrograde ejaculation in which sperm does not leave the body. This can sometimes be reversed, and having sperm extracted from the testicles for use in fertility treatments may also be an option. Having one testicle removed does not usually cause infertility, but infertility is guaranteed if both testicles are removed.

Fertility preservation

Men who would like to have (more) children after their cancer treatment is finished should always discuss their future fertility with their cancer specialist in detail. Your cancer specialist can help you understand how likely your particular treatment plan is to affect your future ability to have children. Sperm banking is always an option for men who are about to undergo cancer treatment of any type. Sperm samples are frozen and they can stay this way basically indefinitely to be used in fertility treatments like artificial insemination, IVF or Intracytoplasmic sperm injection (ICSI) at a point convenient to you and your (future) partner.

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