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Testicular and Prostate Cancer effect on your fertility

Monday, November 25th, 2019

Testicular and Prostate Cancer account for a large percentage of cancer morbidity in men. 

How can Testicular and Prostate Cancer impact your fertility?  

Testicular cancer: 

Testicular cancer is very treatable if it’s caught early. However, cancer and its treatment could affect your chances of becoming a father. 

Testicular cancer can silently impact your fertility for months before it’s diagnosed. It can cause changes in your testosterone levels as well as genetic damage to sperm cells—both of which make it harder to conceive. Tumors from testicular cancer can block or harm the parts of the testes that create sperm.  

Most men have cancer in one testicle and it is removed to treat their cancer. For most of these men, it won’t affect their ability to have children. But for some men, their remaining testicle might not work so well and this could reduce their fertility. Some men have cancer in both testicles and both are removed to treat their cancer. These men are infertile and won't be able to conceive. 

Very rarely, the lymph glands in your tummy (abdomen) might need to be removed by surgery to treat non-seminoma cancer. This surgery can make you ejaculate backward (retrograde ejaculation).  

If you have retrograde ejaculation you won't be able to have children by natural sexual intercourse. But it may be possible to take sperm directly from your testicles or from your urine. The sperm can be used to fertilize your partner directly or with IVF. 

Chemotherapy for testicular cancer causes temporary infertility in most men who have it. Usually, fertility goes back to normal some months after the chemotherapy ends but for some men it doesn't recover. If you have a radiotherapy treatment, your doctor will advise you not to try to conceive and for up to a year afterward. In a healthy testicle, sperm are constantly being made, so any effects from the radiotherapy should usually only last for a few months after treatment ends. 

Prostate cancer: 

It is a type of cancer that occurs in the gland that produces the seminal fluid that nourishes and transports sperm. Once the prostate is removed a man's reproductive health will be affected, so infertility is unavoidable and is considered to be a permanent consequence of surgery.  

Infertility has been linked to the types of chronic prostatitis that cause white blood cells to mix with sperm. That means chronic bacterial prostatitis or asymptomatic inflammatory prostatitis.   Men with low-risk, slow-growing prostate cancer may be able to avoid infertility by choosing surveillance. 

Men who have had radiotherapy or hormone therapy might produce less semen or no semen. Radiotherapy and hormone therapy can also damage sperm and reduce sperm count. So it might be more difficult for you to have children naturally. 

It is still possible for men to be fertile during their treatment with radiotherapy, hormone therapy or chemotherapy. Radiation or hormone or chemotherapy drugs could damage a developing baby. So men are advised to use contraception to avoid pregnancy while having these treatments.  

Different cancer treatments, including medications, chemotherapy, radiation therapy, and hormone therapy, can affect fertility. Sperm production may fall or stop with radiation treatment. It usually comes back again afterward, although the individual may still produce a smaller quantity of sperm. Even with a smaller amount of sperm, the person may still be fertile. 

However, fertility issues should be considered before curative treatment of cancer. if maintaining the possibility of fatherhood is important to you, be sure to discuss with your doctor the options to preserve your fertility.