Late Effects Assessment Programme: Male fertility

Late Effects Assessment Programme: Male fertility

Some cancers and cancer treaments can cause infertility. Attending the Late Effects Assessment Programme (LEAP) will help you understand what the risk might be and answer any other questions you might have.

Will I be infertile from cancer or treatment I had?

Not all cancers and cancer treatments cause infertility, but some do, so it is important to understand your individual risks. Infertility occurs when you stop producing sperm or when your sperm is too damaged. Azoospermia is the term used for having no sperm in semen.

There are two main causes of infertility for males who have survived a childhood cancer:

1. Direct affect on the sperm-producing cells in the testes by:

  • chemotherapy with certain drugs – specifically alkylating agents The most common ones used in treating a childhood cancer are: Ifosphamide, Cyclophosphamide, Procarbazine, Melphalan, Thiotepa, CCNU, and BCNU
  • the greatest risk is from high total doses of these drugs and/or combined with radiation to the brain, pelvis or lower spine
  • radiation to the pelvis, testicles and total body irradiation (TBI)
  • surgery to the testicles or near the prostate (not common)

2. Direct affect on the hormone-producing areas of the brain e.g. The pituitary gland in the brain that controls the production of hormones. These hormones are the follicle stimulating hormone (FSH) and luteinising hormone (LH):

  • radiation or surgery to the brain

Other factors that can affect your risk of infertility are:

  • age at diagnosis or treatment
  • pre-treatment fertility status

How do I know if this is a problem for me?

These are important issues for young people; hormones produced in the brain also regulate growth, as well as when and how, you go through puberty. It is often at this time that problems (if any) may appear. Blood tests can be done to check the hormone levels once you reach puberty. A semen (sperm) analysis can be done at any time to check if you are producing sperm. Sperm have been known to recover up to several years after treatment with some chemotherapy drugs, but this depends on the dose and whether it is combined with other alkylating agents or treatments. Your oncologist will be able to discuss this with you more fully.

There are a number of options available to assist you in fathering a child; if necessary a referral will be made to a specialist fertility clinic where treatments and options that are available can be discussed. If the type of treatment you had means you are at a high risk of your fertility being affected, you will be given more specific information when you come to clinic.

What about my sex life?

Fertility and sexual function are different. Even if you are told you are infertile you can still have a normal sex life.

Should I use contraceptives?

Yes! Do not assume that because you have had some of these treatments you will be infertile. It is important that you take precautions until you are ready to have a family. It is also important to protect yourself from sexually transmitted diseases.

Will my baby have cancer?

Some young cancer survivors worry that the treatment they had may affect their baby, there is no evidence of increased health problems or abnormalities in children of people who have had treatment for cancer. Except for some rare inherited cancers there is also no evidence that children of cancer survivors have an increased risk of developing a cancer compared to other people.

Please note: one in 10 couples are infertile in the general population.

Any of the issues outlined above can be discussed in more detail when you go to a LEAP clinic as the risk of any problems with fertility is difference for everyone.

Where can I get more information?

The following are good websites to checkout:

Fertility Hope: www.fertilehope.org

Fertility Associates: www.fertilityassociates.co.nz

The National Children's Cancer Society: www.thenccs.org

Acknowledgements

All the fact sheets in the Childhood cancer section of this website have been written by health professionals who work in the field of paediatric oncology. They have been reviewed by the members of the National Child Cancer Network (NZ). Medical information is authorised by the National Child Cancer Network Clinical Leader.

Attached Files: 
LEAP: Male fertility (pdf, 0 bytes)

This page last reviewed 27 February 2013.
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