Does prostate cancer affect my husband's fertility?

Question

Hi doctor,

I am a 42-year-old woman. My husband has recently been diagnosed with prostate cancer. While his treatment is being discussed, I cannot help but worry about how this will affect our family planning.

We were trying for a second child, and now I am unsure if conception is possible during or after his treatment. Will prostate cancer or its treatments, like surgery, radiation, or hormone therapy, impact his fertility permanently, or is there an option to preserve sperm for IVF?

As his partner, I am also wondering whether sexual intimacy will be affected during and after treatment, and if that might change my own reproductive health journey.

Can cancer medications impact me indirectly if we try to conceive naturally during treatment? Also, are there any risks for the baby if conception happens after his therapy, or should we wait a certain time before trying again?

Please guide.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

I understand your anxiety. Prostate cancer treatment does indeed have significant implications for both fertility and intimacy. Surgery (radical prostatectomy) typically removes the prostate and seminal vesicles, eliminating semen production and making natural conception impossible.

Sperm banking before surgery is therefore essential if future fertility is a goal, as it allows for assisted reproduction such as IVF (in vitro fertilization).

Radiation therapy can damage sperm DNA (deoxyribonucleic acid) and reduce sperm count permanently, so pre-treatment sperm banking is also strongly advised.

Hormone therapy (androgen deprivation) suppresses testosterone, which in turn lowers libido, erectile function, and sperm production; while some recovery is possible after stopping treatment, it is often only partial.

I suggest the following investigations for your husband:

Semen analysis before starting any cancer treatment.
Fertility counseling with a reproductive endocrinologist.
Oncology clearance to determine the appropriate timing for sperm banking.

He can follow these suggestions:

Sperm cryopreservation before any definitive therapy is recommended if fertility is a priority.
Understand that sexual function may change. Surgery can cause erectile dysfunction due to nerve damage, and radiation may contribute as well. However, treatments exist, including PDE5 (phosphodiesterase type 5) inhibitors, penile injections, vacuum erection devices, and penile implants.
There is no risk of cancer medication exposure to a partner during intercourse.
Conception is not advised during active therapy because of potential sperm DNA (deoxyribonucleic acid) damage. It is safer to wait several months after treatment ends or use frozen sperm, depending on the oncologist's recommendations.
IVF with ICSI (intracytoplasmic sperm injection), using frozen sperm, is the most reliable path to achieve pregnancy post-treatment.

Please clarify which treatment his oncologist is recommending (surgery, radiation, or hormone therapy), and whether you have already consulted a fertility specialist. That information will help refine a more specific plan and timeline for conception.

I hope this answers your query. Feel free to reach out anytime.

Thank you.