I have prostate cancer: will treatment affect my ability to have children?

Normally, conception of a child is reached via sexual intercourse which is followed by ejaculation and the expelling of sperm into the vagina, a process that leads to the sperm meeting the egg and hence fertilization of this egg; production of an embryo that goes on to develop into a foetus.

Healthy men preserve their fertility well beyond their 60s. Hence being diagnosed with prostate cancer is not always a concern. However, in the recent years we have learnt that prostate cancer affects younger men, for whom parenthood can be of the utmost importance.

Prostate cancer treatment, (i.e. chemotherapy, radiation therapy, surgery), can impair sperm production. As a result men who have been treated for prostate cancer may become infertile. Depending on the stage of the disease and treatment choice, some men regain their ability to reproduce while others remain infertile for the rest of their lives, (i.e. after prostatectomy or removal of both testes).

But what does the prostate have to do with reproduction and parenthood??

Sperm in its immature form is produced in the testis with the help of a hormone called testosterone at a region called seminiferous tubes. It is then released for maturation into another organ, called the epididymis which is located adjacent to the testicles. The epididymis is the organ where sperm attains motility and fertilizing capacity. At the time of ejaculation, sperm are expelled from the epididymis through a muscular duct (called the vas deferens) into the urethra. However, in addition to mature sperm and fluid from the testis and epididymis, the contents of the ejaculate comprise secretions from the prostate and seminal vesicles.

The prostate gland is the biggest male gland, an androgen dependent organ, and contributes more than 60% of the fluid volume of the ejaculate. As such, it functions to supply proteins and other nutrients to the seminal fluid essential for sperm movement, penetration and fertilization.

As mentioned above, one of the side effects of prostate cancer treatment affects its function and the function of the adjacent organs. However, with advances in in-vitro fertilization, infertility can be overcome. So, talk to your doctor, get informed and explore your options. If you wish to become a biological father while still choosing the best treatment for prostate cancer, talk to your specialist about sperm banking and/or sperm aspiration before you start treatment.

There is light at the end of the tunnel!

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