Overview

Cancer treatments can damage or kill the cells involved in sperm production. This means that your ability to produce sperm (your fertility) might be reduced or temporarily stopped during treatment. In some cases, sperm production might start again within a few months after completing chemotherapy. However, it can take several years for sperm counts to return to normal and it may not fully recover. 

Freezing sperm samples before starting cancer treatment might give you options to have a baby naturally in the future, when you're fully recovered. Freezing (cryopreservation) involves storing sperm samples at a very low temperature in liquid nitrogen. Sperm stored in this way can be thawed out in the future for fertility treatment.

Before your sperm can be frozen, you’ll need to be tested for HIV and hepatitis B and C.

Your sperm will also be analysed so we know the quality, as this might affect your chances of having a baby in the future.

Not everyone's fertility is affected, and it will depend on the type of treatment you have. After cancer treatment finishes, the fertility clinic can check your fertility.

We realise that the diagnosis of cancer, and coping with the treatment, can be a difficult time for you. We're here to answer any questions or concerns you might have.

Consultation to discuss treatment

It's important to discuss fertility preservation options with our team before starting chemotherapy or radiotherapy. We can give you personalised guidance based on your circumstances, helping you to make informed decisions and explore the most suitable options for preserving fertility.

During your very first appointment, our doctor will take your history and discuss the potential risk of future fertility in relationship to anticipated treatment. We also arrange for you sperm banking as appropriate. We'll ask you to produce a sperm sample, complete consent forms, and have a blood test.

Tests for HIV and hepatitis

In theory, there’s a risk of viral cross-contamination between samples that are stored in liquid nitrogen.

There has never been a report of this happening but, because of the theoretical risk, you must be screened for HIV and hepatitis B and C.

We cannot freeze any eggs, embryos or sperm samples until we’ve had the results of these tests. We currently cannot offer storage if you or your partner tests positive for HIV or hepatitis B or C. If you have any of these viruses, we will direct you to clinics that can offer samples storage.

Giving a sample

A sperm sample is usually produced by masturbating. There are facilities in the fertility unit, where you can give a sample in a separate, private area.

Sometimes it might be possible to produce a sample at home, using the sterile pot provided, and bring it to the fertility clinic. This is only possible if you can get the sperm sample back to the clinic within 1 hour.This might be embarrassing and difficult for some people but please be assured that we’re here to support you and answer any questions you have.

After your first appointment, we strongly advise you to visit the unit another 1 to 3 times to bank more sperm samples.

If you cannot produce sperm with masturbation alone, we can provide medicines or special vibrators. There might also be an option for urgent surgical sperm retrieval. This procedure requires anaesthesia, and we would need to have a review by one of our anaesthetist doctors to assess your fitness for the procedure.

Analysing the quality of your sperm

For some people, cancer can affect the quality of the sperm produced. A sperm analysis will tell us the quality of your sperm. Even if the quality of your sperm is not normal before chemotherapy, we might advise storing it for potential future use. There is a fertility procedure called intracytoplasmic sperm injection (ICSI) that helps many couples to have a baby in the future. Only a small number of viable or ‘good’ sperm are needed to fertilise the eggs.

The doctor can talk to you more about this when the results of the sperm analysis are available.

If you have severe sperm abnormalities or the sample was found to have no sperm (called azoospermia), we can arrange an urgent assessment by a highly skilled andrologist team. They can advise if anything can be done before chemotherapy or if you should complete your main cancer treatments first.

If no sperm was found and you're due to be treated for testicular cancer, we can arrange 'oncotese' without delaying your main treatment. This is a procedure when we search for sperm while you have your surgery for cancer. We have been one of the first clinics in the UK to offer this option of treatment and remain to be one of only few hospitals in the UK, that can offer this option until now.

How long sperm is stored for

The statutory maximum time period for storing sperm for medical reasons is 55 years.

It is a legal requirement to review the need for storage every 10 years.

It’s very important that we can keep in regular contact with you. You might want to store sperm for several years, so it’s possible that you will move during that time. It’s your responsibility to make sure we are told of any change in your circumstances, such as a new address, telephone number or a new partner. If we cannot contact you to find out if you want us to continue to store your sperm, by law they will have to be destroyed.

Legal information about storing sperm

Under the terms of the Human Fertilisation and Embryology Act you must give written consent about:

• the storage of your sperm or embryos
• the length of time they may be stored for
• the purposes your sperm or embryos can be used for (if you have a partner and propose to have a family with them, they can be named on the form)
• any wishes over any embryos created
• what should happen to your sperm samples or embryos if you die or if you are no longer able to change or cancel your consent. You can add specific conditions of your choice

If you store embryos, your partner will need to complete the treatment and storage forms. In the future, both partners involved in the fertility preservation treatment will need to give written consent when the embryos are replaced. If one partner withdraws consent, it’s not possible for us to replace the embryos.

Stored sperm can only be used in the future with your partner if you’ve named them on the HFEA consent forms and signed the appropriate sections.

If you want to change your forms or for further consultations, phone 020 7188 2300 or 020 7188 7188 extension 50426 to arrange an appointment.

It’s important to remember your priorities and wishes might change. You can withdraw or vary the terms of your consent at any time.

Funding for fertility preservation

Funding for the freezing and storage of sperm and embryos is provided by the NHS. You must meet eligibility criteria.

This will be assessed when your doctor refers you to us for fertility preservation. We will be able to check and inform you if you are eligible for NHS funded sperm freezing and storage. There might be a charge for continuing storage after a number of years.

It’s important you remain in regular contact with the unit. Please tell us of any change of address or circumstances.

If you’re not eligible for NHS funding for fertility preservation, you can still have it with us. However, there will be a charge for consultation, screening tests, treatment cycle, and storage. The fertility unit can let you know the prices or visit the Guy's and St Thomas' specialist care website.

Emotional support

Fertility counselling

Our fertility counselling service can provide additional support for you and your partner, and discuss the implications on fertility of the chemotherapy or radiotherapy.

If you’d like to see a counsellor, please call 020 7188 7641 and leave a message.

Your oncology support nurse will also be able to give you support and advice.

Relationship difficulties

The diagnosis of cancer and coping with treatment can be stressful, creating difficulties in physical and emotional relationships.

You might feel differently about yourself, and concerned about how your partner feels about you. Many people are embarrassed, or feel it’s not the most important thing to talk about with their doctor.

We understand it’s difficult to share these feelings but we're here to help and give you support.