Men with testicular cancer who undergo cancer therapy have a significant reduction in fertility. The desire to have children will impact the type and amount of therapy the patient receives.
The highest rate of fertility was for males with surgery and surveillance who did not receive chemotherapy or radiation therapy.
Risk factors for infertility (Table 3, page 735):
(1) cryptorchidism of remaining testis
(2) radiation therapy
Additional risk factors I added:
(3) the presence of any other significant cause for infertility.
(4) higher stage tumor requiring more aggressive therapy
The amount of radiation received affected fertility. Low dose radiation (0.32 Gy) was followed by a gradual recovery of spermatogenesis. A dose greater than 1.4 to 2.6 Gy results in permanent testicular damage, and spermatogenesis may not recover.
It is important for the couple not to become discouraged and give up. Fertility tends to be low for the first few months after therapy. It takes 2 years after chemotherapy and 5 years after radiation therapy for maximum cumulative fertility to be reached.
Semen cryopreservation should be considered prior to starting cancer therapy, especially if infertility is likely to be a problem.
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