a nonprofit organization Cancer & Fertility: A Guide for Young Men supported by CBC Foundation
Partners Fertile Hope is proud to partner with the CBC Foundation, the Lance Armstrong Foundation and Planet Cancer to provide valuable information about cancer and fertility for young men. Contact Us Fertile Hope is a national nonprofit organization dedicated to providing reproductive information, support and hope to cancer patients whose medical treatments present the risk of infertility. For more information or to order additional free booklets, contact us at: 888 994.HOPE www.fertilehope.org Fertile Hope has provided this guide for informational purposes only. Fertile Hope does not endorse, promote or recommend any of the services or procedures referenced herein and is not engaged in redering medical or professional services. Although we make a conscientious effort to provide high quality information, Fertile Hope disclaims any implied guarantee about the accuracy, completeness, timeliness or efficacy of any information provided herein. Fertile Hope, 2004. All rights reserved.
introduction Young adulthood is a time of enormous change. It is when you figure out who you are, who you want to be, and what you want to do with your life. However, when you are diagnosed with cancer as a young man, you face many tough decisions. One of the biggest may be if you want to have children one day. You may experience side effects long after you finish your treatments. Infertility may be one of those effects. A number of fertility options exist both before and after treatment. You may be newly diagnosed or months or years out of treatment. Either way, this booklet will give you the information you need to understand your fertility risks and parenthood options. Hearing you have cancer changes your life. By educating yourself about the risks involved, you can make the best decisions for you.
The Risks: Get the Facts For men, infertility is the inability to father a child. In general, this is when you stop producing sperm or when your sperm is damaged. Infertility is not the same as impotence, which involves sexual functioning. Am i at Risk? Cancer itself can cause infertility. For example, some men with testicular cancer and Hodgkin s disease have low sperm counts even before treatment starts. Cancer treatments can also cause infertility. Chemotherapy, radiation and surgery can all affect your reproductive system. In general, the higher the dose and the longer the treatment, the higher the chance for reproductive problems. Your age, the type of drugs, the location of radiation and other factors can influence your risk. Ask your doctor how your treatments might affect you. Chemotherapy kills rapidly dividing cells throughout the body, including sperm. Radiation also kills rapidly dividing cells like sperm, but only in or around its target area. For example, radiation to or near your testicles can cause infertility. Radiation to your pituitary gland or hormone-producing areas of your brain can also cause infertility by interfering with your normal hormone production.
Bone marrow/stem cell translplant involves high doses of chemotherapy and/or radiation. These procedures present a high risk of infertility. Surgery that removes all or part of the reproductive system can cause infertility. Talk to your doctor about your treatments and the impact they will have on your fertility.
Before Treatment: Preserving Your Options Some cancer treatments can cause infertility, but not all will. Because it is difficult to predict if you will be infertile after treatment, you might want to think about preserving your fertility before your treatment starts. What are My Options? Sperm banking is a simple, proven way to preserve your fertility. Many men have done it and gone on to have children. You can go to a sperm bank or use a program that allows you to make the deposit at home and mail it in. After you provide the sperm sample, it is frozen and can be stored for many years until you are ready to use it. Even if your sperm count is low, sperm banking may be worthwhile because of advances in reproductive medicine. Testicular tissue freezing is an experimental option. You may want to think about it if you cannot bank sperm because you are unable to ejaculate, or if there are no sperm in your semen. It is a one-day surgical procedure. Radiation shielding is when a doctor places special shields over one or both of your testicles. If you are having radiation to one of your testicles or to your pelvic area, this will help reduce the risk of damage to your fertility.
Treatment s Over: Now What? How do i Know if i m Fertile? Sperm analysis is a simple test that can be performed by a doctor after you finish treatment to see if you are producing sperm. The results of the test will help you decide the best options for becoming a father. Sometimes sperm production will start again after treatment. This usually happens in the first two years after treatment, but you could become fertile again years later. You should use contraceptives (like condoms) if you are not ready to become a father and to protect against HIV and other sexually transmitted diseases.
What are My Options for Becoming a Father? Natural conception is an option if your sperm analysis is normal. Many cancer survivors have children naturally after treatment. Before you decide to have children, you should talk to your doctor about how long you should wait after finishing treatment. Assisted reproduction may be an option if your sperm analysis is low or shows no sperm. Infertility doctors may be able to help you. If you banked sperm, a doctor can use it along with eggs from your wife or partner in a process called in vitro fertilization (IVF) to try and create a pregnancy. If you didn t bank sperm, a doctor may be able to find and remove individual sperm in your testicular tissue. A single sperm can now be injected into an egg to create a pregnancy. Donor sperm from another man can be used if no sperm is found in your semen or testicular tissue. Sperm donation programs allow you to select an anonymous donor whose traits and characteristics closely match your own. Adoption is an excellent choice for anyone wanting to become a parent. Adoption agencies may look at your medical history or require a letter from your doctor about your health. It is a good idea to select an agency that is open to working with cancer survivors.
Children After Cancer: Their Health Cancer survivors can father healthy children after cancer. The birth defect rate in children of survivors is similar to the rate in the general population. They also do not appear to be at higher risk for getting cancer, unless the parent s cancer is an inherited type. Talk to your doctor to find out if your cancer is genetic.
Conclusion Remember this: You can have a family. Options exist before and after treatment. Thinking about fertility now can help make sure you have choices when you are ready to become a dad.
Talk to your medical team about your treatment and its late effects on your fertility. Your oncologist should be able to refer you to a reproductive endocrinologist or urologist. Nurses, social workers, religious advisors, psychologists and other survivors can also help you understand your fertility choices.
Questions to Ask Your Doctor (for Young Men) 1. Will my treatment affect my fertility? If so, what is the best way to preserve my fertility? 2. How will I know if I am fertile following treatment? Are there tests that I can take? 3. If I do not preserve my fertility, what are my parenthood options after treatment? 4. If I bank sperm, is there a time limit for using my sperm? 5. Will I have normal sexual desire and functioning after treatment? 6. What are the risks to my children based on my cancer and the treatment I received? 7. Do you know of support options for young men who have cancer or who have lost their fertility because of cancer treatment? 8. Where can I find a facility that offers these services fertility clinics, sperm banks, adoption agencies, etc.?