Infertility after prostate cancer treatment

You might not be able to have children after prostate cancer treatment. This can be difficult to cope with. Understanding why your fertility can be affected and what can help may help you to cope with these changes.

How prostate cancer surgery affects your fertility

A common treatment for prostate cancer is surgery to remove the prostate gland. This is a radical prostatectomy.

After a radical prostatectomy, you will not be able to have children by sexual intercourse. If you want to have children, your doctor might suggest collecting sperm before surgery. The sperm is frozen and stored until you decide you want to use it to have a baby. This is sperm banking.

During a radical prostatectomy, your surgeon removes:

the prostate
2 glands called the seminal vesicles.

Your testicles will continue to make sperm cells but your sperm cannot pass along the tubes and out of your body. Instead, the body reabsorbs the sperm cells back into your body.

So after radical prostatectomy, you no longer ejaculate any semen. But can still have orgasms. These are called dry orgasms or retrograde ejaculation.

Diagram showing surgery to remove the prostate gland

How radiotherapy, hormone therapy and chemotherapy affect your fertility

After radiotherapy or hormone therapy for prostate cancer, you might produce less semen or no semen. These treatments can also damage sperm and reduce your sperm count. So it might be more difficult for you to have children naturally.

It is still possible for men to be fertile during their treatment with radiotherapy, hormone therapy or chemotherapy. It's important to know that these treatments can damage a developing baby. So you should always use contraception to avoid pregnancy while having these treatments.

Sperm collection and storage (sperm banking)

You might consider storing sperm if you think you might want to have children in the future. You need to store sperm before starting treatment.

It might be possible to take sperm directly from your testicles if you have had a radical prostatectomy. The sperm can be used to fertilise your partner directly or with the test tube baby technique (in vitro fertilization or IVF).

Ask your doctor or specialist nurse to refer you to a specialist fertility clinic.

Coping with changes to your fertility

It can be helpful to have more information about any problems or changes you experience. There might also be practical advice or other treatments that can help.

Coping with a low sex drive.

Prostate cancer and its treatment can reduce or make you lose interest in having sex.

Sex and cancer if you are single

If you are single and have cancer, you may have concerns about starting a new relationship or dealing with infertility.

Supporting your partner if they have cancer

You may be wondering how to deal with any changes in your sex life if your partner has cancer. This might include issues around communication, supporting your partner or contraception.

Talking about sexual difficulties

Your sex life is very personal. You may find it difficult to talk with your partner or your doctor about any sexual difficulties you have from treatment.

Your partner is likely to be relieved that you want to talk things over. They could have been trying to find the right time to raise the subject themselves. You may feel even closer after you have talked any difficulties through.

Doctors and nurses deal with these situations all the time. They are used to talking about them so try not to feel embarrassed. They may raise these issues with you during your appointments. But if they don’t, feel free to ask them if you are worried about it.

You can ask them to refer you to a specialist counsellor or a sex therapist.