Male cancer, cryopreservation, and fertility

Revised 2015


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Male Cancer, Cryopreservation, and Fertility 1.pngWhat is the difference between semen and sperm?

This can be confusing since the terms are often used interchangeably in the media and casual conversation. However, they are very different.

Sperm are the male reproductive cells that contain genetic material. A sperm is made up of three main parts: the head, the midpiece, and the tail. Semen is the liquid that is ejaculated and may or may not contain sperm. This liquid is produced by glands in the reproductive system and also contains enzymes and fructose in addition to sperm.

How can cancer treatment affect my ability to have a child?

Chemotherapy or radiation can affect your ability to make sperm or impact the ability of the sperm to fertilize an egg. The type, location, and duration of the treatment can affect whether those changes are temporary or permanent.

For some types of cancer, the reproductive organs are removed or damaged during surgery that is performed to remove the cancer.

Are there options for preserving fertility in men who have been newly diagnosed with cancer?

Yes! Sperm can be collected and frozen for later use before cancer treatment is started. This way, you may be able to have children after your treatment. This process is called cryopreservation or freezing. The kind of cancer you have and the treatments you will receive can determine what your options are.

What is involved in sperm collection?

For many men, collecting sperm to freeze is a simple, noninvasive procedure. You will be shown to a private room, asked to masturbate to orgasm, and collect your semen in a special container.

A usual semen sample will contain around 5-20 million sperm per milliliter and is able to be divided into several vials for storage. Often, since sperm production is affected by many factors, you may be asked to collect more than one sample. This helps to improve your chances of being able to have a child later.

What if I can’t give a sample?

Some men are unwilling or unable to collect a sample through masturbation. For these men, a special condom may be used to collect semen during intercourse.

Other men have a blockage in their reproductive tract; as a result, no sperm are found in their semen. Sperm can be obtained through various procedures that remove them directly from the testicle or reproductive tubes located beside the testicles.

Some men may have a condition that causes sperm and some or all of the semen to collect in the bladder instead of being released through the tip of the penis. For those men, sperm can often be collected from the urine after intercourse.

If a man is unable to ejaculate (release semen during orgasm), there are options. Sperm can be surgically removed from the testicles and injected directly into an egg in a process called intracytoplasmic sperm injection (ICSI). For more information about ICSI, see the ASRM fact sheet titled Intracytoplasmic sperm injection (ICSI).

If a man is not able to ejaculate due to spinal cord injury, vibratory stimulation or electroejaculation can be used. For more information about these techniques, please see the ASRM fact sheet titled Surgical sperm recovery in men with spinal cord injury (SCI).

Male Cancer, Cryopreservation, and Fertility 2.png

How is sperm cryopreserved?

Once collected, the semen sample is mixed with cryoprotectants. These are liquids that help protect the sperm against damage during freezing and thawing. The sample is then frozen by a slow-cooling method or a flashfreezing method called vitrification.

How long can sperm be stored?

Sperm can be stored indefinitely. Sperm that have been frozen for over 20 years have been used to create pregnancies.

Testicular tissue cryopreservation

Because very few sperm are necessary to fertilize an egg in a dish, it is possible to obtain sperm directly from the testicle. In cases where very few sperm are produced, this may be the best option. Additionally, some patients have not yet reached a point of puberty where they have sperm in their ejaculate. It is important to note that it will be necessary to have intracytoplasmic sperm injection (ICSI) when using testicular sperm. For more information see the ASRM fact sheet titled Intracytoplasmic sperm injection (ICSI).

When a boy has not begun to make mature sperm, options are limited. In some research centers across the world, samples of testicular tissue are removed and frozen. When it’s time to attempt pregnancy, the tissue is examined for stem cells. Stem cells are cells that have the potential to develop into many different kinds of cells. The hope is to isolate these few cells and mature them into functional sperm. So far, animal research is promising and human studies are ongoing. It is important to remember that this is an experimental procedure and whether it will be successful is not known.

Conclusion

The most important thing to remember about fertility preservation is that it should be done prior to any cancer treatment if possible. This will give you the best chance of having usable sperm.

Male Fertility/Andrology

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SART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise

Drs. Timothy Hickman and Rashmi Kudesia discuss the links between lifestyle and fertility. Listen to the Episode
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Male Fertility Journey

About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.

View the Patient Journey
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SART Fertility Experts - Urology and Male Reproductive Health

Male infertility is less often discussed than female infertility. Dr. Ajay Nangia discusses when a man should seek help with conceiving.
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Stress and infertility

It is not clear how exactly stress impacts fertility. Read the Fact Sheet
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Male infertility evaluation: what do I need to know?

Infertility is the inability to achieve pregnancy after one year of unprotected sex. View the fact sheet
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Testosterone use and male infertility

Testosterone (also referred to as “T”) is a hormone produced in men by the testes (testicles). View the fact sheet
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SART Fertility Experts - Male Factor

Infertility is not just a female problem. Dan candidly shares his journey with both diagnosis and treatment of male infertility with Dr. Paul Lin.
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SART Fertility Experts - IVF: Cycles of Hope and Heartbreak

Does stress cause infertility or is it the other way round?  Listen to the Episode
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Fertility Options After Vasectomy

Vasectomy is currently one of the most common methods of sterilization in the United States. After your vasectomy, if you change your mind about having children, there are two procedures that can help you have a child with your partner. View the Fact Sheet
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SART Fertility Experts - Male Fertility

Did you know that up to 40% of infertile couples suffer from male factor infertility? Listen to the Episode
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Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
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Optimizing Natural Fertility

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheet
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Optimizing Male Fertility

About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors. View the fact sheet
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Male Fertility and Infertility - a patient education video

Male Factor Infertility is responsible for about 30% of infertility cases and can contribute infertility to an additional 20% of cases. Watch Video
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Infertility

Infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.  Watch Video
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Basic Infertility Evaluation

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch Video
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Infertility Treatments

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch Video
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Understanding Fertility

In this video series, Dr. Roger Lobo explains the basics of infertility, including causes, treatments and coping methods. Watch Video
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Surviving the Roller Coaster Emotions of Infertility Treatment

The experience of infertility is a rollercoaster of hope and disappointment. Treatment presents an opportunity for hope as well as a new set of challenges. Watch Video
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What is intracytoplasmic sperm injection (ICSI)?

A procedure called intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) if a sperm cannot penetrate the outer layer of an egg. Read the Fact Sheet
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Surgical techniques for sperm retrieval: what should I know?

As many as 10% to 15% of infertile men have no sperm in their ejaculate (the fluid released from the penis during orgasm). View the fact sheet
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Weight and fertility

One of the easiest ways to determine if you are underweight or overweight is to calculate your body mass index (BMI). View the fact sheet
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Sperm morphology (shape): Does it affect fertility?

The most common test of a man’s fertility is a semen analysis. View the fact sheet
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Spinal cord injury sperm retrieval

There are several reasons a man with a spinal cord injury (SCI) might have infertility. View the fact sheet
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Varicocele

A varicocele is a variation of normal anatomy in which veins in the scrotum (the sac that holds the testicles) become enlarged and sometimes even visible. View the fact sheet
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Causes of Male Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of male infertility. Watch Video
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Diagnostic Testing for Male Factor Infertility

When a couple has trouble having a baby, there's about a 50-50 chance that the man has a problem contributing to the pregnancy.

  View the Fact Sheet
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FAQ About Infertility

Infertility is not an inconvenience; it's a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Learn the facts
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Male Fertility Infographics

ASRM has prepared infographics to illustrate the subject of  Male Fertility better. View the infographics

Cancer

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SART Fertility Experts - Medically Indicated Fertility Preservation

Cancer therapy can affect future fertility and pregnancy outcomes. 
Listen to the Episode
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Fertility Preservation for Cancer Patients

When a person is facing a cancer diagnosis and treatment, having children later in life may seem like a low priority. However, an important part of cancer treatment is to carefully evaluate each person's medical situation, goals for parenthood, and cancer treatment plan. Watch Video
Patient Ed Icon

Female Cancers, Cryopreservation, and Fertility

Yes! New technology lets your doctor remove and freeze eggs, fertilized eggs (embryos), or ovarian tissue before treating your cancer. This way, you may be able to have children after your treatment. View the Fact Sheet
Infographic Icon

Cancer Infographics

ASRM has prepared infographics to illustrate the subject of Canter and Fertility better. View the Infographics

Fact Sheets/Booklets

View more fact sheets and booklets written by the ASRM Patient Education Committee.
Patient Factsheet teaser

Hormonal Contraception

Hormonal contraceptives contain a progestin (progesterone medicine) with or without an estrogen.
Patient Booklet teaser

Third-Party Reproduction

The phrase “third-party reproduction” refers to involving someone other than the individual or couple that plans to raise the child (intended parent[s]) in the process of reproduction.
Patient Factsheet teaser

Menopausal Transition (Perimenopause): What Is It?

The menopausal transition (perimenopause) is the period that links a woman’s reproductive (childbearing) years and menopause.
Patient Factsheet teaser

Stress and infertility

It is not clear how exactly stress impacts fertility.

Resources For You

The American Society for Reproductive Medicine (ASRM) is committed to providing patients with the highest quality information about reproductive care.

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