The following cancer treatments have known or possible fertility-related side effects:
Chemotherapy
Chemotherapy uses drugs to kill or slow the growth of cancer cells. These are called cytotoxic drugs. Chemotherapy drugs kill fast-growing cells such as cancer cells. The drugs can also affect other cells that grow quickly, such as the reproductive cells.
In men, chemotherapy may reduce or stop the production of sperm. The drugs may also affect the ability of the sperm to move up the fallopian tubes (motility) and alter the sperm’s genetic make-up. The risk of infertility depends on several factors:
- the type of chemotherapy drug/s used – damage to sperm production is more common with drugs in the alkylating class
- the dose and duration of chemotherapy treatment – this will affect how long it takes sperm production to return; in some cases, it may stop. It may start again, but this often takes several years. For some men, sperm production can take up to a decade to improve or it may be permanent.
- your age – less likely to recover your fertility if you are over 40.
Chemotherapy can cause permanent infertility if the cells in the testicles are too damaged to produce healthy, mature sperm again.
Radiotherapy
Radiotherapy (also called radiation therapy) uses x-rays to kill cancer cells or damage them so they cannot grow and multiply. It can be delivered externally by external beam radiation, or given internally. The risk of infertility depends on the area treated, the dose (measured in grays) and the number of treatments.
- External radiotherapy to the pelvic area for prostate, rectal, bladder or anal cancer and some childhood leukaemias may affect sperm production.
- Radiotherapy to the brain may damage the area that controls hormone production (pituitary gland), which affects the production of sperm and affects sex drive.
- Brachytherapy seed implants used for testicular cancer may affect sperm production, but most men recover.
Surgery
Surgery aims to remove the cancer from the body. If surgery removes part or all of a sex organ or if it removes organs in the surrounding area (such as the bladder), your ability to conceive a child will be affected.