Restoring Male Fertility After Childhood Cancer

Testicular cancer and its treatment can affect hormone levels and can also affect your ability to father children after treatment. It’s important to discuss the possible effects with your doctor before starting treatment so you are aware of the risks and what your options might be.

Most boys and men develop cancer in only one testicle. The remaining testicle usually can make enough testosterone (the main male hormone) to keep you healthy. If the other testicle needs to be removed because the cancer is in both testicles or if a new cancer develops in the other testicle, you'll need to take some form of testosterone for the rest of your life. Most often this is a gel or patch that's put on your skin or a monthly injection (shot) given in your doctor’s office. If you need testosterone supplements, talk to your doctor about what form is best for you.

Testicular cancer or its treatment can make you infertile (unable to father a child). Before treatment starts, men who might want to father children may consider storing sperm in a sperm bank for later use. But testicular cancer also can cause low sperm counts, which could make it hard to get a good sample.

Infertility can also be an issue later in life for boys who have had testicular cancer. If a boy has already gone through puberty, sperm banking is often a good option, since the frozen samples are not damaged by long periods of storage. 

In some cases, if one testicle is left, fertility returns after the testicular cancer has been treated. For example, fertility typically returns about 2 years after chemotherapy stops.

The reimplantation of testicular tissue in patients unable to produce sperm after undergoing cancer treatment in childhood has received approval from the ethics committee at the Free University of Brussels, known as the VUB (Vrije Universiteit Brussel). Cancer treatments like chemotherapy and radiation can affect fertility in patients. In those old enough to have started producing sperm, specimens can be collected before treatment and frozen for use in future IVF treatments. In prepubescent children, however, this is obviously not an option.

Evidence-based complementary medicine has shown that therapeutic doses of zinc administration after chemotherapy  in testicular cancer might be potentially useful in declining the off target consequence associated with oxidative stress.

Reference:

Razavi, S., Khadivi, F., Hashemi, F., & Bakhtiari, A. (2019). Effect of Zinc on Spermatogenesis and Sperm Chromatin Condensation in Bleomycin, Etoposide, Cisplatin Treated Rats. Cell journal, 20(4), 521–526. https://doi.org/10.22074/cellj.2019.5522