You Can Become Father After Cancer Treatment
Story 1: Saikat, a 35-years-old school-teacher has been trying to conceive for two years. When he consulted the doctor, it the doctor found that there was no sperms in his semen. Further inquiry revealed that he received chemotherapy for Hodgkin’s Lymphoma (“blood cancer”) when he was 14 years-old. However, he is completely cured of the cancer right now.
Story 2: Pramod, a 30-years-old businessman visited doctor soon after marriage because his inability to ejaculate. He underwent operation in his tummy (abdomen) for lymph node removal when he was diagnosed to have testicular cancer.
What is Fertility Preservation?
Increasing number of cancers are diagnosed in young individuals, who are yet to start their family. Many a times, these cancers are detected at early stage and therefore, are potentially curable with proper cancer treatment. That means, these patients are able to survive for long time.
But often, as a result of the cancer treatment, they are losing their ability to have their own children in future. The question is, can we save both the sides- that is can we cure their cancer without compromising their ability to become the parents. The answer is something called “Fertility Preservation in Cancer Patients”.
How cancer affects the ability to become the parents (fertility)?
Cancers affecting the reproductive organs (testicles) can directly compromise the fertility by affecting the their functions. Surgical removal of these organs will also impair the fertility. Some operations in the tummy can damage the nerve supply to the penis and impair ejaculation. Radiotherapy is very effective mode of treatment of many cancers. But if radiation is applied particularly in the tummy (abdomen), lower part of the tummy (pelvis) or rectum, it can damage the testicles (reduces the sperm production). Chemotherapy for cancer in any parts of the body can damage the testicles. Whether the radiation or chemotherapy will damage the testicles, depends on the age of the patient, the dose and duration of the treatment and the type of the medicines used. Again, in many cases, the testicles can recover their functions completely or partially.
Which patients are eligible for “Fertility Preservation”?
Before fertility preservation, we have to ensure that the cancer is in early stage, that means there is good chance that the patient will survive after cancer-treatment. Secondly, the fertility preservation techniques should not affect the progression of the cancer. Importantly, there should be sufficient time available for fertility preservation, before starting the cancer treatment.
How fertility preservation is done in the cancers of the testicles?
If these cancers are detected in early stage, in many cases, partial removal of these organs is possible, keeping their functions intact, as far as possible. Proper care can be taken during operations in the tummy to keep the ejaculation-ability intact. Your oncologist will discuss with you, if these are feasible in your case.
How fertility preservation is done before radiation or chemotherapy?
The simple way is to collect the semen and freeze it for future use. The easiest and the most commonly used method, to collect the semen is masturbation. You should collect it in the laboratory in a room with adequate privacy and comfort. Please maintain abstinence for 3 to 5 days. That means you should avoid intercourse and masturbation for 3-5 days prior to the test. Get relaxed. Wash your hands properly before the collection. It's important to collect all the semen in the collection pot and not to spill a portion outside.
Do not hesitate to tell your doctor if you feel any problem. Avoidance of stress and counselling help many men to overcome this problem. If your problem during collection is because of problems in erection, some medicine is given to improve your erection. If you have erection but are unable to ejaculate, Vibro-ejaculator can help you.
I have never done masturbation. What should I do?
Do not worry. Some men may have this problem. The options include·
- Vibro-ejaculator-a small device applied on the front part of the penis ("Glans Penis")to stimulate the organ to discharge the semen.
- Non-Toxic-Condom-rubbing the penis against special condom (not ordinary condom).
- Intercourse- Some men feel comfortable to practise coitus interruptus (withdrawing the penis just before ejaculation) using non-toxic condom.
- Electroejaculation-Your prostate gland can be stimulated using a small probe inserted through theanus under general anaesthesia.
- Testicular biopsy- If all of the above method fails, needle can be inserted inside the testes to check whether sperms are produced inside. If that fails,small cut is given in an attempt to collect the sperms from the testes.
What is the success rate of these fertility preservation techniques?
The frozen sperms have very good chance of survival, if they are of good quality. These sperms can be used later (when you wish to have the baby) for IUI (Intrauterine Insemination) or IVF (in vitro fertilization), depending on the condition of your partner.
Will the babies born by these procedures be normal?
There is no evidence that freezing increases the risk of abnormalities of the baby.
How long the frozen sperms be kept?
These can be preserved for at least five years. If you want to preserve them for long time, you need to talk with your laboratory.
If I freeze my sperm,can’t I become father naturally?
If you are freezing your sperms, you are keeping them as “backup support”. In many cases, testicular function can return, at least partially after cancer treatment and you can conceive naturally. But in case, your testicles fail to resume their activities, you can use the frozen materials.
Whom should I contact for fertility preservation?
You must discuss with your oncologist, if fertility preservation applies to you. You also need to consult fertility specialist, to discuss the procedure in details. The procedure must be done in the laboratory, equipped with all ultramodern facilities.
Cancer does not mean the end of the world. Fatherhood is still possible after cancer treatment. Before cancer treatment, please do not hesitate to discuss with your oncologist about the fertility preservation.Please consult fertility Specialist if you want to preserve your fertility.