Cancer a threat to men’s fertility: What every man should know

Cancer is a devastating diagnosis for anyone. But beyond the immediate threat to life, men—especially younger men—face a lesser-discussed long-term risk: infertility.

With survival rates for many cancers steadily improving, the question of life after treatment is gaining prominence, and fertility sits high on that list.

Medical experts now stress that discussions around fertility preservation should begin the moment a cancer diagnosis is made, especially for men of reproductive age.

Treatments that save lives can unfortunately rob patients of the ability to have biological children.

How Cancer and Its Treatments Affect Male Fertility

Chemotherapy, a common treatment for many types of cancer, works by targeting fast-dividing cells. While this effectively attacks cancer cells, it also affects other fast-dividing cells in the body—including sperm-producing cells in the testicles. This can lead to a reduced sperm count (oligospermia), or even complete absence of sperm in semen (azoospermia). In some cases, the damage is temporary, but often, it can be permanent.

Radiation therapy, especially when directed at the pelvic area or brain (where hormone regulation begins), can also impair sperm production. Even low doses may affect fertility, and higher doses can cause long-term or irreversible damage to the testes or hormonal balance.

Surgical procedures, depending on the type and location of cancer, may involve the removal of reproductive organs or affect the nerves and blood vessels needed for erection and ejaculation. For example, surgeries related to testicular, prostate, or colorectal cancer can directly impact reproductive ability.

Hormonal therapies, particularly for prostate cancer, aim to lower or block testosterone. This results in a sharp decline in sperm production, and libido can also suffer significantly.

In some cases, the cancer itself can impair fertility even before treatment begins. Testicular cancer, lymphoma, and leukemia are known to reduce sperm quality or count at the time of diagnosis.

Is Fertility Loss Permanent?

The effects of cancer treatment on fertility vary. Some men regain their fertility months or even years after treatment, while others may remain permanently infertile. This unpredictability has led to an urgent push for early intervention and fertility preservation.

Fertility Preservation: What Can Be Done?

For men who have reached puberty, sperm banking before beginning treatment is the most reliable option. It involves collecting and freezing sperm for future use, and it’s a procedure that can be completed quickly.

However, for prepubescent boys, fertility preservation is more complex. Since they do not yet produce mature sperm, doctors are now exploring experimental approaches like freezing testicular tissue containing sperm-producing stem cells. Researchers hope that in the future, these cells can be reimplanted to restore fertility once the child reaches adulthood.

One such breakthrough was recently reported in the United States, where a childhood cancer survivor received the world’s first known transplant of his own frozen testicular cells. Though it’s too early to know if it will lead to successful sperm production, it represents a significant step forward in fertility preservation for young boys with cancer.

A Call for Awareness

Experts emphasize that fertility preservation is not just a medical issue, but an emotional and psychological one as well. The ability to choose parenthood later in life can greatly affect quality of life, relationships, and mental health in survivors.

As science advances, the hope is that fertility discussions will become a routine part of cancer care. For now, oncologists, patients, and families are urged to act swiftly and explore their options early.

A cancer diagnosis doesn’t have to mean the end of future fatherhood. But preserving that possibility requires timely action, awareness, and access to fertility services.

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