Fertility After Prostate Cancer Treatment

All prostate cancer treatment options affect your ability to release viable sperm. In this way, prostate cancer treatments often cause infertility. This means it is difficult or impossible to get a partner pregnant through sexual intercourse.^1,2

However, many people with prostate cancer are interested in having children in the future. Their best chance of having children is likely to collect and store sperm before starting treatment. This is a practice called sperm banking. Many doctor’s offices now offer fertility counseling and sperm banking. Talk to your doctor about what options are right for you.^1,2

Growing demand to preserve fertility after prostate cancer treatment

A growing number of people who have been treated for prostate cancer want to have the option of raising children. This number is increasing, because more younger men are being diagnosed with prostate cancer.²

Public awareness efforts and prostate-specific antigen (PSA) screening have been effective in lowering the age of a prostate cancer diagnosis. Compared to 50 years ago, 9 times more men under 55 years old are diagnosed with prostate cancer now.²

In addition, the average age for starting families is rising. And advances in prostate cancer treatment are increasing life expectancy for people with prostate cancer.²

These factors have all led to more people with prostate cancer who are young enough to raise children. Fertility counseling and sperm banking are now commonly offered before prostate cancer treatment. About 1 out of 5 people undergoing prostate cancer surgery express interest in sperm banking.²

How does prostate surgery affect fertility?

A common prostate cancer treatment is removal of the prostate gland. This surgery is called a radical prostatectomy. After a radical prostatectomy, you will not be able to produce children by sexual intercourse.^3,4

During the procedure, doctors remove the prostate and the glands that produce semen (seminal vesicles). Semen carries sperm from the testes out of the body. Without semen, sperm cannot leave the body. You can still have orgasms, but you cannot ejaculate semen.^3,4

How do radiation and other therapies affect fertility?

Radiation therapy almost always affects fertility. After radiation, the prostate and seminal vesicles may not produce as much semen. These glands may also produce semen that does not carry sperm. This can make it harder for sperm to leave the body.^3,4

Also, radiation can damage sperm in the testes. The prostate is close to the testes, so radiation aimed at the prostate may affect them as well. However, damage to sperm is becoming less common with more accurate radiation methods. Covering the testicles with a lead shield can also help protect them during radiation therapy.^1,3,4

Hormone therapy and chemotherapy also tend to affect fertility. It might be difficult to get a partner pregnant after any of these treatments.^3,4

What options do I have if I want to have children in the future?

If you want to have children after prostate cancer treatment, the best chance is through sperm banking. This means collecting and storing your sperm before treatment. During sperm banking, semen containing sperm are frozen in liquid nitrogen. After thawing, up to half of sperm will be healthy enough for in vitro fertilization (IVF).^1,4

IVF, sometimes called artificial insemination, involves combining a mother’s eggs and a father’s sperm outside of their bodies in a lab. If the sperm fertilizes an egg, an embryo begins to develop. The embryo is then inserted into the mother’s uterus.⁶

Your doctor should offer the option of sperm banking before you begin prostate cancer treatment. Unfortunately, many doctors do not bring it up with their patients. Before treatment, ask your doctor for a referral to a fertility counselor to discuss this option. Sperm banking is expensive, and it is not an option for every person with sperm.¹

If no sperm was stored before treatment, the other option is to take sperm directly from the testes. This sperm may be used for IVF. Unfortunately, this process has a success rate of under 50 percent.^2,4

How can I cope with changes to my fertility?

Your sex life and family plans are very personal. Unexpected health changes can impact your life in many ways. Problems with fertility have a big emotional burden and can affect your mental health.³

A helpful way to cope with fertility changes is to learn as much about them as possible. Ask your doctor how prostate cancer treatments may affect your ability to have children. Talk to them about what to do if you want children later.³

Your doctor can suggest other ways to cope with changes to your fertility. These may include:³

• Referral to fertility clinics, specialist counselors, or sex therapists
• Finding healthy hobbies
• Joining infertility support groups
• Being open and honest with your partner
• Practicing self-care