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Male Reproductive Health Issues

Some male childhood cancer patients may have problems with their reproductive functions because of certain treatments they received. Reproductive functions include the production of sperm and male hormones and the ability of sperm to fertilize an egg.

The effect, if any, depends on the:

  • Tissues and organs involved in the cancer or treatment
  • Type, dosage, and combination of treatments 
  • Age at the time of therapy

Treatments are available for many conditions that affect the reproductive system.

Testes are part of the male endocrine system. When boys enter puberty, the pituitary gland releases two hormones that tell the testes to produce sperm and testosterone.

Testes are part of the male endocrine system. When boys enter puberty, the pituitary gland releases two hormones that tell the testes to produce sperm and testosterone.

Cancer Treatments That May Affect Male Health

Problems That May Occur

What Survivors Can Do

It is important that boys who are at risk for reproductive health problems have a yearly check-up that includes checking of growth and the progress of puberty.

Males at risk for reproductive health problems should have blood test to check their hormone levels. These blood tests may include levels of FSH, LH, and testosterone. If the health care provider sees problems in these areas, he or she may refer the survivor to an:

  • Endocrinologist – hormone specialist. Boys who have had both testicles removed should have regular checkups with an endocrinologist starting at about age 11.
  • Urologist – specialist in the male reproductive organs
  • Fertility specialist – a physician with additional training in reproduction

Addressing testosterone deficiency

If testosterone deficiency is suspected, testosterone replacement therapy may be recommended. Testosterone is available in skin patches, injections, and topical gel. An endocrinologist will determine which form of therapy is best.

Infertility options

Sexually mature males who are concerned about possible infertility should have a semen analysis. If sperm counts are low or not present, the test should be checked more than once. Sperm counts may recover over time. Also, sperm count can vary from day to day.

Not all insurance companies cover this procedure. Survivors should check before having the test.

Treatment options for infertility or low sperm count are available. Males who banked sperm before treatment should consult with a fertility specialist when ready to father children.

Continue to use birth control

Men should not rely on low, or absent, sperm counts to prevent pregnancy, as pregnancy can occur with low sperm counts.

For more information, visit the Children’s Oncology Group’s Male Health Issues after Cancer Treatment.


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Reviewed: June 2020