Sperm storage before treatment

If your sperm is suitable and you would like to store some for the future, you will need to produce a number of sperm samples over a period of a few days. These can be frozen and stored for some time by the hospital. When you want to father a child, your sperm can be thawed and used to artificially inseminate your partner.

Unfortunately, not every man has sperm suitable for banking. To be successfully stored, it is thought that a sample must contain a certain number of active sperm cells, which would be able to fertilise a female egg. However, new techniques now make it possible for less active sperm to be effective.
 
It is best to discuss possible sperm storage with your doctor before your treatment starts, so that tests can be done to check your sperm count.
 
For many patients with cancer, the cancer unit will provide free sperm banking. But if the hospital has to pay for this service, they may need to charge the patient. The cost can vary between hospitals.

Sometimes your doctor may feel that it is important to start chemotherapy treatment quickly. In this situation there may not be enough time to arrange for sperm banking to be done before the treatment starts.

Follow up

After your treatment has been completed, your doctor will want you to have regular check-ups, blood tests, scans and x-rays. These will continue for several years. If you have any problems, or notice any new symptoms in between these times, you should let your doctor know as soon as possible.

Affect on sex life and fertility

One of the commonest questions asked by men before and after treatment for testicular cancer is whether their sex life will be affected.

The important thing to remember is that the removal of one testicle will not affect your sexual performance or your ability to father children, if the other testicle is healthy. This is because the remaining healthy testicle will produce more testosterone and sperm to make up for the removal of the affected testicle.

Chemotherapy usually causes infertility during and for a time after treatment in men with testicular cancer. This is usually temporary but for some men it may be permanent. For this reason it is usually advisable to store sperm before starting chemotherapy treatment. The rate at which the sperm count recovers varies from person to person, but it generally returns to normal within two to three years.

The effect of chemotherapy on semen (the liquid that contains the sperm) and sperm is uncertain. Because of this it is advisable to use a condom during treatment and for about a month after treatment (this protects your partner and avoids any stinging sensation for your partner). Although there is no evidence that chemotherapy can harm children fathered after the treatment has finished, doctors usually advise that you avoid having a child for about a year after treatment.

Some men with testicular cancer have a low sperm count before they start any treatment, and sometimes successful treatment with chemotherapy may actually cause the sperm production to improve.

Sometimes it is necessary to surgically remove lymph glands in the abdomen, if they are still enlarged after radiotherapy or chemotherapy. Unfortunately, this can affect your fertility, as the operation can damage the nerves that control the discharge of sperm through the penis (ejaculation). However, new surgical techniques mean that this problem can usually be avoided. If there is a possibility that you may need such surgery, and if you are fit enough to produce sperm samples for storage before treatment starts, some of your sperm can be stored.

Although this further surgery may make it more difficult for you to father a child, it will have no physical effect on your ability to get an erection or have an orgasm.

Radiotherapy does not normally cause sterility. However, a small dose of radiation does reach the remaining testicle. There is no evidence that this radiotherapy has any effect on children fathered after the treatment, but men are usually advised to use contraceptives for 6-12 months after treatment has ended.

Any course of treatment may make you too tired to be interested in sex. This is called loss of libido and is common to many illnesses, not just cancer. It is worrying, but remember that it is a temporary side effect and once treatment is over and your body begins to return to normal, your libido will also return.

Sexual problems are very personal and very important and talking about them can be a great help.

Although this can sometimes be difficult, once they have summoned up the courage to talk openly to their partners, many men find that their fears of rejection are unfounded. Sexual relationships are built on many things including love, trust and common experiences. You may even find a new closeness after talking through a problem with your partner.

In some cases, your doctor, nurse, close friend or relative may also be able to offer help and advice. Some hospitals have nurses or social workers who have been specially trained to help people with sexual problems.

One common fear is that cancer cells can be passed on to your partner during sex. This is not true. Cancer is not infectious and it is perfectly safe for you to have sexual intercourse.

Your feelings

Most people feel overwhelmed when they are told they have cancer, even if the chance of cure is very high, as it usually is with testicular cancer. Many different emotions arise which can cause confusion and frequent changes of mood. You might not experience all the feelings associated with being diagnosed with testicular cancer, but they may occur. This does not mean, however, that you are not coping with your illness.

Reactions differ from one person to another - there is no right or wrong way to feel. These emotions are part of the process that many people go through in trying to come to terms with their illness. Partners, family members and friends often experience similar feelings and frequently need as much support and guidance in coping with their feelings as you do.

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