by Dr. Louis Weckstein
If you have recently been diagnosed with cancer or have made it through cancer treatment this is a very stressful time. With all the other things you need to do to take care of yourself it’s hard to be thinking about your fertility, but it may be critical to plan now for the future. Depending on the type of cancer, surgery, chemotherapy or radiation therapy that your medical team recommends you may want to quickly bank sperm before your treatment.
Sperm samples are often poor because of the stress and effect of cancer on your body and reproductive system, so you should bank as many samples as possible before treatment.
Treatments for some types of cancer and some combinations of chemotherapy are less likely to effect sperm than others, so ask your medical team how your treatment plan is likely to affect your future fertility. Three to six months after your last chemotherapy or treatment you can check your sperm to see how it may have been affected by the treatment. If the sperm count and motility are normal it is often recommended to wait for up to one year after your last chemotherapy to make sure you are healthy and also to diminish any possible effect of the chemotherapy on the health of a pregnancy (though there is limited hard data to support this).
If the sperm testing shows no sperm or very low sperm count or motility you may decide to move forward with using your banked sperm (though sometimes sperm recovery can eventually occur even a year or more after treatment). At this point a consultation with a fertility center can help you evaluate the quantity and quality of the sperm you have frozen as well as your partner’s fertility. Since female fertility declines significantly with age the older your partner is the more important it is to have prompt evaluation and treatment.
Treatment options will depend on the sperm quantity and quality as well as female fertility factors and age. In some situations with a significant amount of banked sperm intrauterine insemination may be a reasonable option to begin treatment. Pregnancy rates with good quality sperm may range from 5-15 percent per treatment cycle. If there is a very limited amount of sperm banked or the quality is very poor, it may be best to immediately start with in vitro fertilization, with pregnancy rates as high as 40-50 percent per treatment cycle. Also consider your desire for additional pregnancies in the future when deciding how aggressive to be with treatment depending on how much of your precious sperm you have banked.
A good fertility center can help you during and after these stressful times to make the best reproductive choices to have your family.
Dr. Louis Weckstein is a leading Reproductive Endocrinology and Infertility specialist at the Reproductive Science Center of the San Francisco Bay Area, where he has served as the medical and IVF director since 1997. Dr. Weckstein has particular interest and experience in all aspects of IVF, including Egg Donation and fertility in older women. He loves his job and is very appreciative to be able to work in a field where so many couples have been helped to achieve their dream of having a family.
