Written by Ben Bunting: BA(Hons), PGCert.
Chemotherapy is one of the most toxic treatments in medicine. Nonetheless, such a treatment is justified, as it is lifesaving in many cases.
In this article we shall cover the following points:
- What's chemotherapy?
- Male infertility post chemo
- Sperm regeneration
- Long-term effects
What is chemotherapy?
Chemotherapeutic agents or medications are not as selective as doctors would like. Thus, they kill cancer cells and cause considerable collateral damage as they are toxic for almost every body tissue.
Chemotherapy medications are highly toxic for cells. If any of the body’s cells are exposed to large amounts of these drugs, they will die.
Anti-cancer treatment works because cancer cells have a higher metabolism; they absorb these drugs in large quantities. Moreover, these drugs have a high affinity for cancer cells.
Fortunately, the body tries its best to protect some critical organs like the brain, eyes, and testicles through a strong barrier for the blood.
Consequently, blood, toxins, and metabolites find it hard to enter testicles due to the blood-testis barrier. Nevertheless, small amounts of them make into the testis, causing significant damage and decline in fertility levels.
So, yes, chemotherapy is quite toxic for testicles and may considerably reduce male fertility in many cases.
Male infertility after chemotherapy
First and foremost, it is vital to understand that not all infertility cases in cancer patients are related to chemotherapy.
Thus, for example, in many instances, cancer may itself cause infertility. In some cases, the tumor may disrupt ejaculation. In addition, some cancers produce hormones, causing a negative impact on male fertility.
However, cancer treatment using chemotherapy is often the cause of infertility in cancer patients. It may occur due to many reasons.
Some cancer treatment drugs are less selective and cause widespread damage. They are also highly toxic for stem cells in the testicles which produce the sperm.
Some of the drugs used to treat cancer that cause infertility are alkylating agents, platinum-based agents, vinca alkaloids, antimetabolites, topoisomerase inhibitors.
Another way in which chemotherapy may negatively affect sperm production is that it is often used along with hormone therapy.
Again, it is because cancers like prostate cancer may need the use of prolonged hormone therapy. Such treatment may considerably prolong life but may lead to infertility.
Of course, not all cancer infertility cases are related to chemotherapy. After all, most cancer treatments use three kinds of treatment:
- surgical removal of the tumor
Needless to say, radiotherapy and surgery may also cause considerable damage to male fertility.
Regretfully, chemotherapy in cancer is not only targeted towards cancer cells. For example, many individuals may receive bone marrow transplants.
But, that is not all. Many cases of infertility could be due to indirect causes. Like chemotherapy may affect nerve cells.
This would not only influence sperm production but would significantly reduce erectile function. Inability to have sex may also contribute to infertility or impotence.
Further, it is vital to understand that cancer diagnosis causes significant emotional distress in all individuals, additional stress can also impact fertility.
This is yet another factor contributing to the drug toxicity and thus higher chances of infertility after chemotherapy in some individuals.
Regretfully, many of those affected by cancer are young adults, and they would like to have children in the future.
Chemotherapy can help completely eradicate cancer in many cases, or it may result in a considerable increase in survivability.
It means that thanks to chemotherapy, long-term survivors are increasing, and saying no to chemotherapy is not an option.
However, the increasing number of long-term survivors also means that number of males living with infertility after chemotherapy is continually rising.
It is true that treatment can help revive sperm production in most cases, but not in all cases. Studies show that about one-fourth of long-term survivors remain sub-fertile or infertile even after intensive treatment for their condition. These individuals continue to live with significantly low sperm production.
Studies suggest that about 50% of patients diagnosed with chemotherapy-related infertility may hope to revive their sperm production after almost two years of discontinuation of the therapy.
And, these figures may rise to about 80% after five years. But, of course, these statistics matter for those who could conquer cancer or are long-term survivors.
Fortunately, in most cases of infertility, there is some sperm production. It means that there is always a hope of improving the fertility rate.
Consequently, it means that those affected by chemotherapy can still have biological children.
It is vital to understand that chemotherapy would cause sub-fertility or infertility in almost all cases. Thus, it would be good for young adults to consider other options before starting chemotherapy.
Some of the options could be sperm banking, testicular tissue freezing, and so on. In some cases, doctors may use testicular sperm extraction if a person cannot produce semen samples.
Further, testicular shields may help those undergoing radiation therapy.
Thus, experts highly recommend that all men undergoing chemotherapy should ask their treating doctors about the possibility of infertility after the treatment.
It is vital to understand the risk from the treating doctor as not all kinds of anticancer drugs cause infertility.
Moreover, knowing that a drug may cause infertility may help people to prepare beforehand. For example, one may use the services of sperm banking.
Quite often, doctors treating cancer can advise regarding options available. In addition, they can also recommend fertility treatment.
To conclude, chemotherapy is associated with a considerable decline in fertility and may also cause infertility.
Therefore, it is something that everyone who needs to go through chemotherapy must know. This way, a person can look at various options to have a child in the future.
Of course, it is also good to know that things are not that bad. A considerable number of those who have undergone chemotherapy may expect the revival of their fertility through adequate treatment.
Further, chemotherapy-related sexual dysfunction is also treated with significant success these days.