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Parenthood was not always a concern for men who were diagnosed with prostate cancer because the average male who was diagnosed was over 60. Today, however, better testing is catching prostate cancer earlier in younger men for whom the ability to father children may be an issue. Prostate cancer treatments could cause men to become temporarily or permanently infertile, which is the inability to conceive after one year of unprotected sex.
From the point of puberty on, men
produce millions of sperm at a time. Until the sperm
is needed, it is kept in the testicles. A luteinising
hormone then stimulates the testicles to produce
testosterone,
which ignites the sex drive. Under normal circumstances,
a sperm through sexual intercourse fertilizes an egg.
Here a man reaches an erection, then ejaculates sperm
into the vagina. Some prostate cancer treatments cause
the production of sperm to be stopped for a short time
or permanently.
One of the prostate’s functions
is to provide for the delivery of sperm. Prostate cancer
treatments seek to destroy cancer cells in the prostate
before they have an opportunity to metastasize.
Different forms of prostate cancer treatment can influence
the ability to remain fertile.
Radiation Therapy
For some patients, interstitial radiation
therapy can cause permanent infertility. The chance
of infertility is closely associated with the dose of
radiation administered. Depending on the dose received,
it may take up to five years to reach normal fertility
again. Fertility may not be affected if a patient undergoes
brachytherapy
with iodine-125
seeds, which is one type of radiation therapy.
Surgery
Some operations can affect fertility, leaving men unable to father a child. Men will not be able to father biologically after both testicles are removed or the prostate gland is removed.
Chemotherapy
Chemotherapy
can cause temporary or permanent infertility depending
on the types of drugs given, the dose administered,
whether a combination of drugs was used, age, and general
health. The chance of fertility decreases with certain
drugs, higher doses, combination methods, and if you
are older and in bad health.
Hormone Therapy
Although certain hormones can affect fertility, generally the problems only exist while patients undergoing treatment. Once completed, men should achieve normal fertility.
Take steps to preserve your ability to biologically father after prostate cancer treatment. With recent advances in infertility techniques, many men are choosing to bank their sperm prior to undergoing treatment. Men with a low sperm count in their ejaculate are opting for sperm aspiration either prior to or after treatment. If you do not believe it is important to father a biological child, but still wish to have children, consider adoption or sperm donation. The best way to prepare for the future is to understand your risk of infertility after treatment. Plan ahead, consult your physician, and stay informed.
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