However, it's important to be sure you understand important instructions to follow during and after brachytherapy, such as:. Radiation for prostate cancer from a machine outside the body is more likely to cause permanent infertility, even if the testicles are shielded. During puberty the testicles start making sperm, and they normally will keep doing so for the rest of a man's life.
Certain chemotherapy drugs given during childhood, however, can damage testicles and affect their ability to produce sperm. Certain types of chemotherapy later in life can also affect sperm production. Cells start out as offspring of other cells that have divided. When cells are new, they are immature and not functioning fully. Chemotherapy chemo works by killing cells in the body that are dividing quickly. Since sperm cells divide quickly, they are an easy target for damage by chemo.
Permanent infertility can result if all the immature cells in the testicles that divide to make new sperm spermatogonial stem cells are damaged to the point that they can no longer produce maturing sperm cells. After chemo treatment, sperm production slows down or might stop altogether. Some sperm production might return, but can take many years, and sometimes does not return at all. Chemo drugs that are linked to the risk of infertility in males include:.
Higher doses of these drugs are more likely to cause permanent fertility changes, and combinations of drugs can have greater effects. The risks of permanent infertility are even higher when males are treated with both chemo and radiation therapy to the abdomen belly or pelvis. Some other chemo drugs, such as those listed here, have a lower risk of causing infertility in males:. Talk to your doctor about the chemo drugs you will get and the fertility risks that come with them. Targeted therapy and immunotherapy drugs attack cancer cells differently from standard chemo drugs.
Little is known about their effects on fertility or problems during pregnancy. Males taking thalidomide or lenalidomide have a high risk of causing birth defects in a fetus exposed to these drugs, which can stay in semen for a few months after treatment ends. Oncologists recommend that males and any sexual partner who is able to get pregnant use extremely effective forms of birth control, for example a condom for the man and a long-acting hormone contraceptive or IUD for the woman.
See Targeted Therapy and Immunotherapy to learn more about these cancer treatments. Some hormone therapies used to treat prostate or other cancers can affect hormones that help to develop sperm. Sperm production and numbers can be lower. This can affect your ability to have a child. These drugs can also cause sexual side effects, such as a lower sex drive and problems with erections, while patients are taking them. The decrease in sperm production and the sexual side effects tend to improve once these drugs are stopped.
Having a bone marrow or stem cell transplant usually involves receiving high doses of chemo and sometimes radiation to the whole body before the procedure. In most cases, these procedures have the side of effect of permanently preventing a male's ability to make sperm.
All cancer survivors deal with the idea that cancer could return. Survivors and their partners must talk about the chances that the child will be raised by only 1 parent. This decision is very difficult and personal. Consider talking with a counselor for guidance. Some cancer treatments make it difficult or impossible for survivors to have children. All men and women who want to have children should talk with their health care team about potential infertility before treatment begins.
They should also discuss options to preserve fertility. Having a baby is a big decision. No matter what treatment you have had, you should talk with your health care team about the potential risks of pregnancy and birth. Your doctor may need to check certain organs to make sure your pregnancy is safe. You may be referred to an obstetrician. This is a specialized doctor who is trained to care for women during and shortly after a pregnancy. Pregnancy after cancer treatment Often, pregnancy after cancer treatment is safe for both the mother and baby.
How cancer treatments may affect pregnancy Treatments can affect a future pregnancy in many ways: Radiation therapy. Fathering a child after cancer treatment Men can try to have a child after cancer treatment ends.
Other concerns about having a child after cancer treatment Risk of children getting cancer. Talking with your health care team Having a baby is a big decision. This is a specialized doctor who is trained to care for women during and shortly after a pregnancy Questions to ask your health care team Consider asking the following questions: Will my cancer treatment plan affect my ability to have children? To evaluate your options, consider the risks and successes of each.
Currently, the most established options are sperm banking for men and embryo freezing for women. Learning about all the options available to you may help you feel better about your choices. Protect what's important to you. If you have always wanted to have children, don't let others minimize this desire, including your health care team.
Sometimes cancer-related infertility is not discussed as often as it should be. The disease takes priority, which is understandable and necessary. However, you still have a right to protect your ability to have children in the future. Consider the challenges. When researching your options, keep in mind that many are costly and may not be covered by your health insurance. Also, some options are time-consuming, and you may not be able to postpone treatment as long as you need to. Don't be afraid to get a second opinion before making important decisions.
Seek out resources. Ask your doctor about available fertility resources and referrals, such as reproductive endocrinologists, sperm banks, financial assistance, and adoption agencies. Talk to a fertility counselor or join a support group. Learn about pregnancy risks. Talk with your doctor about when is a safe time to begin a pregnancy.
Your doctor may advise you to avoid pregnancy during cancer treatment, as some treatments may cause birth defects or harm to the developing fetus. Also, you may need to wait for a period of time after treatment to avoid miscarriage or premature birth. Don't give up. The French National Cancer Plan recommends the service be expanded across the country. The researchers sent a survey to 96 breast cancer survivors between the ages of 18 and 40 who were treated with chemotherapy for nonmetastatic breast cancer, of whom 60 agreed to participate.
The median age at diagnosis was 36 years, and the median time between the end of their chemotherapy and participation in the study was 57 months.
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