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Cancer and fertility: a guide for men with testicular cancer

Patient information A-Z

You have recently been told that you are going to need treatment for your cancer. This treatment, chemotherapy, radiotherapy or surgery may damage your ability to father a child naturally.

This leaflet will offer you some information about sperm banking. The choice to have fertility treatment is yours. We can advise you about sperm banking and refer you to Cambridge IVF for more detailed information, discussion and sperm collection and storage.

Sperm banking

Why does my sperm need to be stored?

Cancer and its treatments can sometimes lower the number of sperm produced leading to infertility. In the majority of cases this is only temporary and the sperm count will return to normal within two years of finishing treatment. However, for a number of men who receive chemotherapy, or radiotherapy directly to the testicle, the sperm count will not recover, resulting in infertility. Successful sperm banking before treatment can preserve the possibility of fathering a child at a later date using the stored sperm should this happen to you.

What is sperm banking?

Sperm banking is the preservation (or saving) of sperm by freezing so it may be used at some time in the future for artificial insemination or other assisted reproduction technique. You will be referred to a specialist fertility clinic by your doctor/ specialist nurse for this.

What will happen when I attend the fertility clinic?

You will have a consultation with a specialist and will be given the opportunity to discuss your fertility concerns and ask any questions about their procedures. If you have a partner, it may be a good idea for them to accompany you so they can be present during these discussions. You should not ejaculate for at least 72 hours prior to your visit as you will be asked to produce a sperm sample for analysis and storage. This is done via masturbation into a container in a private room at the clinic. You will be given complete privacy to do this and your partner may accompany you if you wish. The number of visits you will need to make to the clinic will depend upon the urgency with which you need to start your treatment and the judgment of the fertility specialist. It is possible for you to attend immediately after your first cycle of treatment, if required, as the testis will still contain some healthy sperm produced before the chemotherapy.

The sperm sample is produced through masturbation and not everyone is able to produce a sample in such unusual circumstances. It will be understood that you are under considerable physical and emotional stress, and you should not feel embarrassed if this happens to you. It may be possible to make further visit to the clinic. For some men, having testicular cancer can result in a low sperm count, due to hormonal imbalance, and it is possible that you could be informed that you are infertile and are unable to bank any sperm. Occasionally, the sperm count can improve when treatment has been completed and in this instance, we may recommend a sperm analysis two years after completing chemotherapy.

What about the quality of the sperm?

In most men, having testicular cancer will not affect the quality of the sperm. Storing sperm of good quality gives a realistic chance of fathering a child at a later date through assisted conception. However, no pregnancy is guaranteed. Occasionally, due to illness, sperm quality may have deteriorated. Freezing and then thawing sperm can also cause a percentage of them to stop moving. You can be reassured that you cannot pass on cancer to a partner via your sperm and there has been no link seen between children conceived after chemotherapy and problems at birth or in the baby’s development.

Do I need any tests before I can bank my sperm?

The Human Fertilisation and Embryology Association (HFEA) require that the blood of men storing sperm is screened for HIV, hepatitis B and hepatitis C. This is to preserve the safety of any future partners and children conceived using the sperm. Your team of doctors and nurses will arrange this for you. If you have any concerns regarding giving your consent for these tests, please discuss this with you doctor or nurse and we can arrange for you to see a counsellor experienced in these matters.

What happens in the future?

Fertility can be slow to recover after treatment and we would not recommend retesting your sperm count until two years after completing chemotherapy. At this point a result would provide the long term picture of your fertility. If you are fertile, you may decide to ask for your stored sperm to be destroyed. If the result suggests your sperm count is low or absent, the standard practice is to store your semen for 10 years and renew this consent every 10 years as appropriate for a maximum of 55 years in total. It is essential you keep the fertility clinic notified of any changes in your circumstances, such as a change of address and GP, as they will need to contact you in the future.

What about funding?

At present the NHS will meet the cost of the initial consultations, blood tests and storage. Further funding for fertility treatment is under review and you should discuss this with a member of the testicular cancer team at the appropriate time.

Legal requirements

There are a number of legal requirements about the storage of sperm. You will be asked to sign consent forms agreeing to treatment and storage of your sperm. You will also be asked what you would like to do with them in the event of your premature death.

Finding Cambridge IVF

Cambridge IVF (01223 349010) is easy to access by car, public transport and bicycle. When approaching the centre along Trumpington Road, look out for Bidwells Estate Agent on the corner of Maris Lane. Kefford House is immediately behind this complex of buildings and shares a parking lot with them.

Getting here by car
The centre is just off Trumpington Road, easily accessible from the M11 and A11 if coming from outside Cambridge. There is plenty of parking at the centre. You can also park at the Trumpington Park and Ride and take a bus. There is a stop close to the centre on Trumpington Road (see below).

Location of Cambridge IVF on a map
Finding Cambridge IVF

By bus
The Trumpington Park and Ride service (Stagecoach route number 88) stops at Anstey Way, on the corner of Maris Lane going towards Cambridge. You can get the same bus from Downing Street in Cambridge city centre. NB: Do not get the guided bus service from the Park and Ride to Addenbrooke's hospital, as it does not pass Cambridge IVF. The Citi 7 bus also runs between Cambridge city centre and Trumpington, stopping at the Anstey Way stop and at Cambridge Station.

By train
If arriving in Cambridge by train, you can take the Citi 7 bus to the centre as described above.

Cycling
Cambridge IVF is easily accessible by bicycle. There are good cycle lanes along Trumpington Road which connect with a network of on and off road routes. There is covered bicycle parking at the centre.

We are smoke-free

Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.

Other formats

Help accessing this information in other formats is available. To find out more about the services we provide, please visit our patient information help page (see link below) or telephone 01223 256998. www.cuh.nhs.uk/contact-us/accessible-information/

Contact us

Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge
CB2 0QQ

Telephone +44 (0)1223 245151
https://www.cuh.nhs.uk/contact-us/contact-enquiries/