Infertility in Male Childhood Cancer Patients

Infertility can be a side effect of certain childhood cancer treatments. Infertility is the inability to get a partner pregnant after a year or more of regular sexual intercourse without using any birth control methods.

Before therapy starts, families are encouraged to discuss the impact of treatment on the patient’s fertility. The pediatric cancer center may also have a fertility specialist who can discuss options to preserve fertility.

The testes (testicles) in men produce testosterone and sperm. Puberty begins in boys when the brain instructs their bodies to start producing testosterone. When sperm from a man fertilizes an egg in a woman, she becomes pregnant.

The testes (testicles) in men produce testosterone and sperm. Puberty begins in boys when the brain instructs their bodies to start producing testosterone. When sperm from a man fertilizes an egg in a woman, she becomes pregnant.

How the Male Reproductive System Works

To understand fertility, it’s helpful to understand how the male reproductive system works.

The testes (testicles) are located in a loosely hanging pouch of skin known as the scrotum. In men, testes produce sperm and the male hormone testosterone. When sperm fertilizes an egg, a pregnancy occurs.

When boys enter puberty, the pituitary gland releases hormones that stimulate testosterone production. Testosterone regulates many processes that assist in the transition of a boy into manhood. These processes include the maturing of sperm and the development of male sex organs.

Testosterone also regulates male functions such as:

  • Deepening of the voice
  • Enlarging of the penis and testicles
  • Increasing the growth of facial and body hair
  • Enhancing muscular development

How Cancer Treatment Affects Fertility in Males

Treatment that affects a patient’s reproductive organs, and pituitary gland may have an impact on a patient’s fertility.

Take Action Before Treatment Starts

Before treatment begins, parents and the patient, if old enough, should talk with the care team about the effect cancer treatment could have on the patient’s ability to have children.

  • If the treatment could affect fertility, ask the medical team what actions can be taken to protect fertility.
  • Find out the cost of treatments and if it is covered by insurance.

Procedures That Can Preserve Fertility

Questions to Ask Before Treatment Begins

When your son is so young, it may seem strange to discuss fertility options. But many health care providers believe that having the discussion before treatment begins is the best time.

Consider asking questions such as:

  • Could treatment increase the risk of, or cause, infertility?
  • Are there other recommended cancer treatments that might not cause fertility problems?
  • Which fertility preservation options would you advise?
  • What fertility preservation options are available at this hospital? At a fertility clinic?
  • Would you recommend a fertility specialist (such as a reproductive endocrinologist)?
  • Is condom use advised, based on the treatment I’m receiving?
  • What are the chances that my fertility will return after treatment?
  • How much do these fertility options cost? Are they covered by insurance? Are there financial resources available?


Reviewed: July 2020