Sperm Banking: Fertility Options for Men Undergoing Cancer Treatment
Since his diagnosis with testicular cancer in 1996, Lance Armstrong has beaten cancer, won the Tour De France seven times, and fathered three children. How does he do it? Well, maybe no one but Lance knows all the secrets of his success, but we know at least one: sperm banking.
Yes, all three of the great athlete’s children are the result of a decision he made long before he met his wife. There is no way around it, a diagnosis of cancer brings us face to face with our own mortality. But for certain men being treated for certain types of cancer, it also brings them face to face with their immortality. Fortunately, there is hope: sperm banking.
So, if you have no plans to become a father at this time, or ever, sperm banking will allow you to change your mind at a future date. Here’s what you need to know.
What Is Sperm Banking?
Some types of cancer treatment may affect your fertility temporarily. Others may affect it permanently. Unfortunately, there is no way to predict how your treatment will affect your fertility.
In sperm banking, your sperm are frozen (this is called cryopreservation) and stored so that should you decide to become a father at some point in the future, you will have that opportunity, even if the cancer treatment has affected your fertility.
In order to bank your sperm, you will need to collect a sample of your semen. This usually takes place in a private collection room at a sperm bank. You may choose to collect the sample on your own or you may have your wife or partner come into the room with you.
Once your sample is collected, it will be tested to determine your sperm count (how many sperm cells it contains) and the sperm motility level (how active the sperm cells are). Your sperm is also tested for sexually transmitted diseases, including hepatitis and HIV, as these viruses can be transmitted in the semen. Then, it is placed in a special container and frozen at extremely low temperatures.
How Does Cancer Treatment Affect Sperm Production?
Your testicles are responsible for producing both testosterone (the male hormone) and sperm. So, while chemotherapy may not affect your testosterone level, it may reduce your sperm count. In fact, it is quite probable that you will experience some period of infertility after chemotherapy.
High doses of chemotherapy, such as those given before a bone marrow or stem cell transplant may cause permanent sterility. Radiation therapy, particularly whole-body irradiation or radiation aimed at or near a man's testicles, may also affect sperm production. Some cancer surgeries, such as those for prostate or testicular cancer, require men to have parts of their reproductive system removed. These surgeries may damage the nerves important for normal ejaculation.
Making the Decision
The decision to bank your sperm is a highly personal one. If you are married or in a committed relationship, it is best if your partner is a part of your decision. If you are under the age of 18, you might want to discuss it with your parents.
Time, however, is of the essence, as you will want to begin your treatment as quickly as possible. If you think sperm banking is an option for you, discuss the matter with your doctor as early after your diagnosis as possible. It is best to arrange sperm banking before your treatment begins.
Will Sperm Banking Delay My Treatment?
Storing semen samples does not have to delay the start of medical treatment, but it may temporarily delay your sex life. This is because even though sperm are constantly being produced in the testes, it takes some time to replenish the sperm level after each ejaculation. Therefore, to allow for high semen volume, a sample is best after 48 hours of sexual abstinence. If possible, the same amount of time should pass before the collection of the second sample. If the scheduling of your treatment does not allow that much time, waiting 24 hours between collections is usually enough.
What Influences Sperm Quality?
Sperm quality is measured in one of several ways:
- Sperm count (the number of sperm present in one milliliter of seminal fluid)
- Sperm motility (the level of activity of the sperm cells)
- Morphology (the percentage of sperm cells that have a normal shape)
Once you’ve finished your cancer treatment, your semen quality may not be what it was before your treatment. This is likely due to either the disease itself or the medications/therapies required to treat your disease.
Is It Worth Banking Semen if the Quality Is Not Optimal?
Even if you have a low sperm count or low motility, it may make sense to bank your sperm. New techniques in in vitro fertilization can often achieve pregnancy by injecting just one live sperm into an egg.
How Long Can My Sperm Be Stored Safely?
Semen samples can be safely stored in this frozen state for 10 years or longer. Sperm from a teenage boy or a young man that is banked before his cancer treatment should be viable years later when he is ready to become a father.
Will My Children Be Healthy?
Like Lance’s kids, literally thousands of children have been conceived with sperm that has been frozen. Currently, there is no evidence to suggest that pregnancies produced with frozen sperm increase the chance of birth defects.
American Cancer Society
National Cancer Institute
Infertility: sperm bank. Glickman Urological Institute website. Available at: http://www.clevelandclinic.org/. Accessed October 14, 2003.
Sperm banking. Reproductive Health Council of the American Foundation for Urologic Disease, Inc. website. Available at: http://www.reproductive-health.org/. Accessed October 14, 2003.
Last reviewed July 2007 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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