Fertility for Prepubescent Boys with Cancer

If you have a child with cancer, treatment side effects may include infertility. Learn how you can help preserve your child's fertility.

Before Cancer Treatment

You should always talk to your son’s health care team to discuss the risks and benefits of any procedure, including the ones listed in this article. Pre-pubescent boys do not have the option of sperm banking because the testicles do not contain mature sperm. Currently, there are two fertility preservation options available for pre-pubescent boys.

Testicular Tissue Freezing
Testicular tissue freezing is an outpatient surgical procedure that can be done before treatment for men either before or after puberty. In many cases it is the only option for prepubescent boys. Testicular tissue, including the cells that produce sperm, is surgically removed, frozen, analyzed and stored. The procedure is experimental with no live births to date but shows promise for the future.

Testicular tissue freezing is the only options available before puberty. In this procedure, small pieces of testicular tissue are surgically removed before cancer treatment and frozen for future use. While this procedure shows a lot of promise, it is still considered experimental. Testicular tissue freezing has not yet resulted in a successful pregnancy.

Testicular Shielding
If your son is undergoing radiation, his health care team can place shields over his pelvic area. Testicular shielding will help decrease both the amount of radiation to his testicles and the damage to his fertility.

After Cancer Treatment

After your son finishes treatment, there may be effects on his growth and development. In boys, puberty normally begins between the ages of 13 and 15. Your son’s development may be affected if he has radiation to his testicles or the hormone-producing areas of the brain such as the pituitary gland. Radiation therapy to these areas may interfere with the production of testosterone, which could put your son at risk for early or delayed puberty.

Hormone Replacement Therapy
Delayed puberty may be caused by too little testosterone. This can be treated with hormone replacement therapy (HRT) to help your son enter into puberty and maintain masculine development once puberty starts.

Semen Analysis
After your son has entered puberty a health care provider can perform a semen analysis to check for sperm production. Sperm production can start months to years after treatment.

Parenthood Options

Today cancer survivors have many successful options available to start a family. By the time your son is ready to be a father, continued medical advances may provide even more options than are currently available.

Natural Conception
If your son is producing sperm, natural conception may be possible.

Testicular Sperm Extraction
If your son is not producing sperm by the time he is ready to become a father, a method called “testicular sperm extraction” can be considered. If sperm can be found within his testicular tissue, a single sperm can now be extracted and injected into an egg to achieve pregnancy.

Donor Sperm and Adoption
For cases of infertility, your son may want to weigh the options of donor sperm or adoption. Read more in the Parenthood Options for Men article.

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