Fertility Concerns After Childhood Cancer for (Cis) Boys and Men
Fertility (or the ability to have children) after cancer therapy is a very complex topic. It can be hard to tell if and how treatment will affect your fertility. It is related to:
- The doses and types of medications given.
- If radiation or surgery to reproductive organs was done.
- Your age at the time of treatment.
What therapies cause the most risk?
Certain treatments are thought to have a higher risk of affecting fertility. These are:
- Chemotherapy with alkylating agents (like cyclophosphamide and ifosfamide).
- Bone marrow/stem cell transplants.
- Radiation to the testicles and/or brain (which signals the testicles to make sperm and testosterone).
- Total body irradiation (TBI) can affect your testes and brain.
- Surgery involving the testicles, prostate, or other areas of the pelvis.
We do not know if newer treatments like targeted therapy and immunotherapy will impact reproductive health.
How can I learn about my fertility?
Cis boys/men who want to father a child or learn more about their fertility should see a reproductive specialist who works with cancer survivors. They are often called Oncofertility specialists. They can do testing to check your fertility, including certain hormone levels and sperm counts.
Your provider may tell you that you can or cannot father a child, but they never know for sure. You should always use reliable birth control if you do not wish to father a child.
Learn more about fertility preservation here.
Resources for More Information
Provides education and information to cancer patients regarding fertility risks as well as referrals to access fertility preservation discounts.
Offers support for embryo, semen, oocyte, and ovarian tissue freezing and storage, as well as fertility preservation information.
The Oncofertility Consortium
Provides a telephone support hotline, education, and clinic/center search options for people with cancer coping with infertility or potential loss of fertility due to cancer treatments.
Website of the National Infertility Association. Provides education, advocacy, and information about fertility preservation as well as a database of support groups. Includes information about insurance coverage.
Long-Term Follow Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers. Version 5.0, 2018. Accessed at: http://www.survivorshipguidelines.org/pdf/2018/COG_LTFU_Guidelines_v5.pdf