Your Fertility and Cancer Treatment 

You may be thinking about whether cancer treatment could affect your fertility and future family planning. This can be a hard topic to talk about, and you are not alone. Some cancers and some treatments can lower fertility. If you are thinking about future family planning, ask your care team about the options available to you. 

Key point: It is best to ask about fertility before treatment starts, if possible. 

• Radiation near the testicles and some chemotherapy drugs can harm fertility. 

• Some surgeries can affect the parts of the body needed to make or release sperm. 

• It is hard to know if or when fertility will return. 

• Your doctor may tell you to wait before trying to start a pregnancy after treatment. 

Before Treatment: Saving Sperm for Later 

If you have gone through puberty, you may be able to save sperm before treatment starts. This is called sperm banking. A semen sample is collected and frozen so it may be used later. For many people, this offers hope and more choices for the future. In most cases, it does not delay treatment for long. Costs and insurance coverage can vary, so ask your care team or social worker if cost is a concern. 

• Try to bank sperm before chemotherapy or radiation starts. 

• More than one sample can help, but even one sample may still be useful. 

• Some people may be able to bank sperm even if they have only recently started puberty. Ask your care team what may be possible. 

• Some places offer home collection kits or local collection options. 

• You may be asked to sign forms about what will happen to the sperm in the future. 

If You Feel Nervous About Sperm Banking 

Many people feel stressed, embarrassed, or uncomfortable about sperm banking. That is very common. Your care team has helped other patients through this, and they can help you also. 

• Ask where the sample is collected and how your privacy will be protected. 

• Bring music or try slow breathing if you feel anxious. 

• Tell the staff if you need more time or have concerns. 

 If Giving a Sample Is Hard or Not Possible  

If you cannot ejaculate, a fertility specialist may still be able to help collect sperm. Some centers offer procedures to do this while you are asleep under anesthesia. Another option may be a small procedure to collect sperm directly from the reproductive tract or testicle. 

 If needed, sperm may be collected directly from the testicle or nearby tissue during a small procedure. Your doctor can explain if this option is right for you and how it may be used in future fertility treatment.  

You do not have to figure this out alone. Your care team can help you understand your choices. Where to Find Support 

• Ask your cancer team, nurse navigator, fertility specialist, or social worker about fertility support and financial assistance. 

• The Alliance for Fertility Preservation (https://www.allianceforfertilitypreservation.org/) is a nonprofit organization that provides a comprehensive directory of US programs offering fertility services to cancer patients (Fertility Scout), a list of states that mandate insurance coverage for fertility preservation, and links to all programs that help cancer patients with the costs of fertility preservation 

Finding expert help for fertility