Men's fertility and chemotherapy

Some chemotherapy drugs can affect a man’s fertility. Talk to your doctor about your risk of infertility. They can tell you more about the possibility of storing sperm.

How chemotherapy affects fertility

Being infertile means you cannot have children.

Not all chemotherapy drugs affect your ability to get someone pregnant. But some drugs can:

• reduce the number of sperm you produce
• affect the sperm's ability to fertilise an egg
• affect the production of the hormone testosterone

The infertility may be temporary or permanent. It depends on the drugs you have, the doses and your age. Permanent infertility is more likely if you have higher doses of chemotherapy. 

Some chemotherapy drugs can affect the nerves in the genital area. This can make it difficult for you to get or maintain an erection. This is usually temporary and gradually gets better once the treatment has finished.

Most men can still get an erection and have an orgasm as they did before treatment. Chemotherapy doesn't usually have any permanent effect on your sexual performance or your enjoyment of sex.

Sperm banking

Sperm banking means collecting and storing your sperm. You can then use the sperm later to have a baby through fertility treatment.

It’s important to talk to your doctor about the risk of infertility before you start chemotherapy. You can then make decisions about whether to use a sperm bank.

You need to store your sperm before starting treatment if there is a risk that treatment will affect your fertility.

What happens

You have tests first for infections such as hepatitis and HIV. You can still bank your sperm if you have one of these infections, but it will be stored differently.

You should avoid having sex for at least 2 days before your sperm banking appointment. You might need to produce several samples of sperm. These are frozen and stored. 

Using the sperm

A specialist clinic can store your sperm for many years. The clinic will contact you every 10 years to check you still want it kept. It is important to let them know if your details change.

When you and your partner want a baby, the clinic specialists thaw the samples. They then use them to inseminate your partner. Inseminate means putting your sperm into your partner to start a pregnancy. Many people have had healthy babies after fertility treatment following chemotherapy.

Possible problems

Sometimes it isn’t possible for you to bank sperm. This could be because the cancer has made your sperm count very low. Or sometimes your doctor may want to start treatment very quickly. In this case it may not be possible to store sperm or to store only one sample. 

Sperm banking is not always available on the NHS and there may be a charge.

Checking your fertility

If chemotherapy has made you infertile, it can be difficult to tell whether this is permanent or not. Some men will stay infertile. Others find their sperm returns to normal and their fertility comes back.

It can take a few months or sometimes years for fertility to return to normal. To check your fertility, your doctor can do regular sperm counts for you when your treatment is over.

Coping with infertility

It can be very difficult to learn that you may no longer be able to have children. There is support available to help you cope.

That Cancer Conversation

That Cancer Conversation is Cancer Research UK's podcast. In the episode exploring infertility and cancer, we chat with people whose cancer journey has had an impact on their fertility.

It also features Professor Richard Anderson, Deputy Director of the University of Edinburgh’s Centre for Reproductive Health. We explore options that are available and what the future of fertility medicine could look like.