Just because you have had treatment for cancer doesn’t mean you will have problems with fertility – but this is something you need to think about if you are about to start treatment, and may want to have a family in the future.

• In this fact sheet we will explain some of the fertility options available to you before you start treatment.

• For more information on how cancer treatment’s can affect your fertility please visit our fact sheet, fertility info for men.

• If you have already completed your cancer treatment, check out our fertility options after treatment for men fact sheet for fertility information once treatment has finished.

A good idea is to talk to your doctor about your treatment and how it could affect your fertility.

Below are a list of questions to help get you started:

Questions to ask your doctor:

• What are the risks of infertility with my treatment plan?

• What can I do to preserve my fertility?

• How much time do I have before I start treatment?

• What can I do during treatment to protect my fertility?

• Who do I need to talk to about my fertility options?

• Can you refer me to a fertility clinic?

• How do I know if I will be fertile after treatment?

Your doctor should discuss the risk to your fertility before you start treatment. Please make sure that your doctor knows that your fertility is a priority for you.

There are some options available which are listed below.

Not all of these options may be available or right for you. You need to talk to your doctor about what is appropriate.

Sperm Freezing

• Sperm freezing involves making a sperm deposit and then having it frozen.

• You generally go to a clinic (called an andrology clinic), which could either be part of the hospital or a separate IVF/fertility clinic. If you are well enough, you may be able to do this at home.

• You will be told step-by-step what to do by the staff there, and given as much time as you need. This can be a bit of an embarrassing or awkward situation for a lot of people (especially if you have to be taken there by your parents), but the doctors and nurses do this every day and will try to make you feel as comfortable as possible.

• To give you some idea of what will happen, you will be required to masturbate (you may know this as ‘wanking’, ‘jerking off’ or ‘jacking off’) and ejaculate samples of your sperm for collection into a jar.

You will probably be asked to give a couple of samples, generally three, but not all in one go. The reason for this is because your sperm might not be of high quality because of the cancer.

• If time allows, you may be asked to wait 2-3 days between each collection to give the sperm time to build up again. This might not be possible though depending on your treatment protocol and how fast your doctor needs to start treatment.

• Once you have a sample, the sperm will be frozen. It is then clearly labelled with your details and stored in a large tank of liquid nitrogen where the temperature is maintained at -196°C.

The storage tanks are not run on electricity or through machines but work like thermos flasks.

Radiation Shielding

• If the testes are close to where the radiation is directed (but they are not the target for radiation), then they can be shielded from the radiation beams by using protective coverings.

• This technique does not guarantee that the radiation will not affect your testes, but it does provide some level of protection. Your doctor will probably still recommend that you bank sperm.

Other options

• There are other options that are only used in rare instances. These involve using a needle to remove some sperm from the testes (testicular sperm extraction), usually with a light general anaesthetic.

• They are only used for boys and men who are unable to produce a sperm sample by masturbation.

• If you are in a relationship and find it hard to produce a masturbated specimen, you may be able to collect some sperm into a special condom during intercourse and bring it into the lab.

This is NOT a normal condom, but one which is specially designed for this purpose.