Your San Diego fertility center: Reproductive Sciences Center & Genetics Institute

Male Fertility Treatment for Men with Cancer

Advances in the treatment of cancer have led to impressive improvements in the long-term prognosis of patients. Unfortunately, a major complication of these increasingly effective cancer therapies is reproductive failure resulting in men's temporary and even permanent infertility or sterility. We offer a range of technologies to help male cancer patients preserve their fertility. Reproductive Sciences Center has provided comprehensive fertility services to oncology patients for over 10 years.

Options for Men

Cancer treatment adversely affects sperm quality and can lead to infertility. We strongly encourage patients to freeze semen, preferably before initiation of cancer treatment to preserve fertility. Patients may have to undergo radiation, chemotherapy, or surgery as part of medical management. Each of these treatments has deleterious effects on sperm production or emission and can thus contribute to infertility. Certain types of cancer may also affect sperm quality even prior to the beginning of treatment.

Commonly asked questions

Which patients benefit from sperm banking?
Recent studies have shown that semen from patients with many cancer types including testicular, seminoma, prostate, lymphoma, leukemia, and Hodgkin's can be successfully frozen, i.e. cryopreserved, even when sperm counts are low (as is true for about 50% of patients with testicular cancer).

When is the optimal time to bank sperm?
Due to potential genetic damage caused by chemotherapy, it is recommended that sperm be frozen before cancer treatment is initiated.

Can men with very low sperm counts or poor quality sperm successfully freeze sperm?
Yes, even for semen with the poorest quality and quantity of sperm, cryopreservation can still be an option when used with assisted reproductive technologies such as IVF and intracytoplasmic sperm injection (ICSI).

Can men with complete absence of sperm successfully cryopreserve sperm?
Yes, as long as at least one testis has zones of sperm production (spermatogenesis), sperm can be retrieved surgically from the epididymis (tubules adjacent to the testis where sperm is stored) or the testicular tissue and frozen for future use with ICSI.

Is it possible to predict who will later make use of sperm banking?
No, studies have shown it is not possible to reliably predict the fertility status for the individual patient after treatment. The probability of return of healthy sperm production varies according to age of patient at time of cancer treatment, treatment regimen used and type of disease.

Are there any risks associated with cryopreservation?
Yes, all tissue banking has inherent risks associated with loss of cell viability that can result from unforeseen equipment failure or environmental disaster. The Reproductive Sciences Center takes all reasonable precautions to avoid adverse outcomes, including test thaws on all sperm specimens and 24 hour monitoring of storage tanks.

How long can cryopreserved material be stored at Reproductive Sciences Center?
Specimens may be stored virtually indefinitely. Prolonged storage requires special arrangement with our center including current contact information. Patients are notified annually regarding number of vials of specimens in storage.

What is the genetic effect of cancer treatment on sperm?
Few studies have assessed the genetic effect of cancer treatment on sperm. Data so far from small patient populations show no evidence for a higher incidence of congenital malformations (birth defects) in children of former male cancer patients. However, there is evidence that during the period of recovery of sperm production (up to 2 years following treatment), there is a higher percentage of aneuploid sperm (genetically abnormal sperm with missing or extra chromosomes) which might result in higher rates of pregnancy loss, still birth and birth defects.

How and why should sperm DNA damage be assessed?
The structural organization of sperm DNA is vital for the proper functioning of the sperm. It is not clear whether cancer itself or the various cancer treatment regimens are capable of inducing structural changes in the sperm DNA. High levels of sperm DNA damage are associated with higher miscarriage rates and lower pregnancy rates in assisted fertilization techniques. The level of DNA integrity can be assessed in a sperm sample using the SCSA (sperm chromatin structure assay). We recommend the SCSA for all sperm specimens intended for use in fertility treatment.

More information for cancer patients is also available at FerileHope.