My husband has prostate cancer. How do we prevent infertility?

Hello,

Welcome to icliniq.com.

I understand your concern.

Diagnosis of prostate cancer at 35 is indeed unusual, and you are both concerned about fertility.

Let me explain your concerns here. Fertility and prostate cancer treatment, such as radical prostatectomy (surgical removal of the prostate) and radiation therapy (including external beam or brachytherapy), can significantly affect fertility in the following ways:

1. After prostatectomy, ejaculation is lost (dry orgasms) because the seminal vesicles and vas deferens are removed or disrupted.

2. Radiation may damage the sperm-producing ability of the testes over time and also impair ejaculation.

3. Hormone therapy (sometimes given along with radiation) reduces testosterone levels, temporarily suppressing sperm production.

A few methods to preserve your fertility are:

1. Sperm banking (cryopreservation) before starting treatment. Your husband should preserve his sperm, ideally multiple samples, at a certified fertility center. Semen is collected (usually via masturbation) and frozen in liquid nitrogen for future use.

2. This allows for IUI (intrauterine insemination) or IVF (in vitro fertilization) later, depending on the quality and count of sperm. It is a quick, low-risk, and highly effective method. You can go for sperm DNA (deoxyribonucleic acid) fragmentation testing if time allows, to assess quality more accurately.

3. Unfortunately, all definitive treatments for prostate cancer are likely to impact fertility. However, if his cancer is very low risk (Gleason score 6, PSA less than 10, organ-confined) and not aggressive, active surveillance may be considered, delaying treatment while closely monitoring the disease.

These procedures can help you conceive naturally, but they must be carefully discussed with a urologist and oncologist, since your husband is quite young and the cancer biology must be favorable. Also, I suggest you schedule a sperm banking appointment immediately, before you begin any treatment.

Request a fertility consultation at a reproductive center and speak with your urologic oncologist about the possibility of active surveillance (if the cancer is low-grade).

Ask whether nerve-sparing surgery is being considered; while this will not preserve fertility, it may improve post-operative sexual function. You must discuss the following with your doctor:

1. What is the Gleason score and stage of the cancer?

2. Is active surveillance a safe option in his case?

3. Can sperm banking delay treatment?

4. Will nerve-sparing surgery be performed?

Kindly share your biopsy report and PSA values. I can advise further based on risk level.

I hope this information helps you.

Thank you.