Can You Still Be Fertile After Having Prostate Cancer?
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Treatment for prostate cancer may interfere with your ability to have children. If you have a prostatectomy, you will not be able to father children, because the prostate makes the seminal fluid. You cannot ejaculate without seminal fluid. Your testes make the sperm, but when there is no seminal fluid the sperm cannot get out of the testicles. Most men who have prostate cancer are of an age where they are no longer interested in fathering children; the average age when prostate cancer is discovered is at age 60.
Nerve function
As a result of new, life saving, technology, younger men in their 40s and 50s are being diagnosed and treated for prostate cancer. There is now technology for robot assisted surgeries that save nerve function, which is necessary for erectile function. If you are a man who wants to father children, you should have a discussion with your oncologist or primary care physician about your fertility, and other factors involved with fathering children. Besides fertility, you might also be concerned about the possibility of erectile dysfunction. Erectile problems may be temporary or they may be permanent after treatment for prostate cancer. If erectile problems are permanent, there are medications that can be given to improve erectile function.
Radiation
Younger men, who have prostate cancer, sometimes find it difficult to cope with the changes that are taking place in their body. Depending on how your prostate cancer is treated, you may or may not have a problem with fertility. For instance, if you have external beam radiation (EBR) therapy, you may lose fertility for up to 5 years or more. Some men never gain back their fertility. If you have brachytherapy (seed implantation) with radioactive iodine-125, your fertility may not be affected. If you are a man who still wants to father children, you might want to talk to your doctor about brachytherapy.
Younger men, diagnosed with prostate cancer, should make their doctors aware if they still want to father children. Chemotherapy can interfere with fertility. Depending on the dosage and combination of drugs used in chemo, you could temporarily or permanently lose your fertility. The higher the dosage of chemotherapy drugs used to treat prostate cancer, the lower your chances of being fertile.
Hormone therapy (estrogen) might be one of the better options for a man who wants to maintain his fertility. He will lose his fertility while he is in hormone treatment, but once the hormone therapy is completed, normal fertility should return. Some men don’t like the side effects of taking estrogen, so they opt to have an orchiectomy. An orchiectomy is surgical castration. Removing the testes will remove your ability to make sperm.
Sperm extraction
If you are a man considering an orchiectomy, and you still want to father children, you may ask your doctor about banking your sperm before surgery. Your doctor can send you to a specialist that can do testicular sperm extraction (TESE). During TESE the doctor removes a small portion of testicular tissue and extracts sperm cells to be stored for a future in vitro fertilization (IVF). Microsurgical epididymal sperm aspiration is another type of sperm aspiration that is taken from the epididymis, which is taken from the top of the testicles.
If treatment for prostate cancer does interfere with your fertility, and you are anxious to father children, you might want to consider donor sperm to use for in vitro fertilization. You also might want to consider adopting children. For many men, being a dad is more than biology; therefore adoption or in vitro with donor sperm is always a viable option. It is important for every younger man with prostate cancer, who is concerned about his fertility, to consult with his physician about his concerns.
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