Pregnancy after Chemotherapy

Last Modified: July 23, 2006

Dear OncoLink "Ask The Experts,"

My husband is 30 years old and was diagnosed with testicular cancer (stage II, 100% embryonal carcinoma). He immediately had surgery and chemotherapy (BEP for 3 cycles). His last chemo treatment was about 8 months ago.

Prior to the cancer, my husband and I had been trying to start a family. We would really like to start trying again. I am unable to find anything online that clearly states how long one must wait [to try to conceive after treatment] and when sperm production is expected to return to normal. His oncologist stated that 'reproductive biologists' recommend that men wait 2 years after chemo to begin trying, but in the same breath he stated that we should be okay if we were to conceive a year after.

Are there any statistics available that clearly show what the best wait time is? When will my husband expect to have a 'normal' sperm count?

Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:

We generally say wait 2 years because we know that time period is safe from a genetic damage perspective. Here is some of what is known:

Sperm cells exposed to chemotherapy or radiation therapy may suffer genetic damage. This damage appears to be repaired two years after treatment.
Growing eggs exposed to chemotherapy or radiation may suffer genetic damage. This damage appears to be repaired within six months.
Rates of birth defects in the general population are 2% to 3%. Rates of birth defects in children born after one parent's cancer treatment appear similar; they are no higher than 6%, and probably less.
No unusual cancer risk has been identified in the offspring of cancer survivors (except in families identified with true genetic cancer syndromes, for example, inherited retinoblastoma).

The other issue is whether or not the chemotherapy has caused your husband to be infertile. You could have his semen tested for viable sperm, but then again, you could also just try to conceive and cross that bridge if you come to it. I have cared for quite a few patients who were told they would not be fertile, but next thing they new they were pregnant, so it is not an exact science.

A great resource is www.fertilehope.org.