Male Infertility: Suggestions

Below is a list of options for cancer survivors who are concerned about their fertility.

Sperm Banking

• Before beginning chemotherapy or radiation, you produce a semen sample at a medical laboratory or sperm bank.
• A semen analysis is done. As long as the sample contains some live sperm cells, it can be frozen and stored for future use in infertility treatment.
• Once frozen, samples can be kept for at least 10 to 15 years, probably longer, without further damage.

Cost: Most health insurance plans do not cover the cost of storing frozen semen although many do pay for the semen analysis. Many sperm banks have monthly payment plans to make banking more affordable for cancer survivors.

Who can do it: Men who have reached puberty, even boys as young as 12 or 13, can bank sperm as long as the semen contains enough live and healthy sperm.

Where to bank sperm: Most large cities have sperm banks that you can find listed in the yellow pages. A member of your health care team may be able to give you a referral. If a sperm bank is not located near your home, you can find sperm banks on the Internet. Ask a member of your health care team if the sperm bank is reputable.

Some sperm banks provide express mail kits to men who want to collect their semen at home. Some work with a local laboratory to process your sample and send it to the bank.

In Vitro Fertilization - Intracytoplasmic Sperm Injection (IVF-ICSI)

• This treatment became available in 1992.
• The woman who will carry the child must undergo hormone shots for several weeks to stimulate her ovaries to ripen more than one or two eggs.
• Her eggs are “harvested” in minor outpatient surgery.
• The eggs are cleaned in the laboratory and stored in individual dishes, ready for fertilization.
• The embryologist uses a special microscope to choose a healthy-looking sperm and injects it into an egg. If all goes well, several embryos can be created.
• One, two or, occasionally, three embryos can be placed into the uterus of the female partner in the hopes that they will implant and start a pregnancy.

Cost: IVF-ICSI is expensive and involves some medical risks for the woman. But it is also very successful, especially if the woman has normal fertility and is younger than 35.

Who can do it: Since only a few sperm are needed, IVF-ICSI is a good option for men who have poor semen quality or have sperm with poor motility.

Intrauterine Insemination (IUI)

This option is for men with semen quality that is closer to normal.

• A man’s semen sample is purified and concentrated to contain as many active sperm as possible.
• In a doctor’s office, the sample is put in a thin catheter (tube) and slipped directly through the woman’s cervix into her uterus, giving the sperm a head start on fertilizing the egg.
• The procedure is done at a woman’s midcycle, her fertile time of month. Sometimes the woman is given extra hormones to ripen more than one egg, but not in the high doses used in IVF.

Donor Insemination

• A man donates his sperm. The survivor may choose someone he knows or can use donor sperm from a sperm bank.
• The donor semen is used as in IUI to create a pregnancy

Adoption

Adoption is accepting legal responsibility for an orphaned child. Contact an adoption agency for more information.

Cost: The process can be expensive ($5,000 to $40,000) and may take a long time.

Who can do it: Adoption agencies have screening processes for anyone who wants to adopt. Discuss with your health care team any documentation you might need to confirm that you are healthy and able to care for a child.

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