Summary
Men who have completed treatment who want children and didn't bank sperm prior to treatment still have a chance of using their own sperm to have a child - even if the sperm has to be extracted.
There are different situations for men who suffered loss of the prostate and seminal vescicles, men with dry orgasm because of damage to nerves during cancer treatment and for men who produce no sperm.
If all else fails, adoption is an option.
For information,see:
Use Of Your Own Sperm
After treatment, most men recover some ability to produce sperm cells. If the sperm counts and movement (motility) are close to normal, men may be able to father a child through sexual intercourse (natural conception). If only a few sperm are present in the semen, men may need to use infertility treatment methods, such as intrauterine insemination or IVF-ICSI.
Even when men have no sperm in samples of their semen, small areas of sperm production may still exist in the testicle. In this case, a surgeon using a microscope can take several samples of tissue to look for sperm to use in IVF-ICSI. This is called testicular sperm extraction, or TESE for short.
Sperm extraction:
Epididymal sperm aspiration and testicular sperm extraction (TESE) are investigational options for men who do not have mature sperm cells in their semen, either before or after cancer treatments. Either requires minor surgery done by a specialist. In micro-epididymal sperm aspiration, a tiny opening is made in the epididymis (the coiled tubes that sit on top of the testicle), and sperm are sucked out with a needle. In TESE, tiny pieces of tissue are removed from the testicles and checked for sperm cells. If mature sperm are found, they can be used immediately for IVF-ICSI or frozen for future use. Insurance rarely covers the cost of this treatment. Since these sperm must be used with IVF-ICSI, the cost of that treatment must be added.
For Loss Of Prostate And Seminal Vesicles
If you have had prostate or bladder cancer, surgery was probably done to remove your prostate gland and the seminal vesicles (the organs that produce most of the fluid for semen). This means that your body no longer makes semen. Also, the ends of the vas deferens (small tubes running from each testicle to the prostate) are generally cut during this type of cancer surgery, like they are for a vasectomy, so there is no way for the sperm to get outside your body. With enough mental or physical sexual excitement, you should still be able to have the pleasurable feeling of orgasm (climax), but it will be a "dry" orgasm.
If there is no semen coming from the penis during orgasm, conceiving a child during sex is not an option. But there are ways that sperm can be taken out and used to fertilize an egg. An infertility specialist can take sperm from the epididymis (the tiny tubes where sperm cells ripen at the top of the testicles) or use TESE, as described above.
For Dry Orgasm Because Of Damage To Nerves During Cancer Treatment
Some men have dry orgasm after surgery for colon cancer or after removal of lymph nodes as part of treatment for testicular cancer. But if you still have your prostate and seminal vesicles, several treatments may work. For some men in this situation, the prostate and seminal vesicles are completely paralyzed. They normally squeeze and relax rhythmically as a man's climax begins, but nerve damage can keep this from happening.
If nerve damage is mild, the prostate and seminal vesicles may still work normally. Often, though, the valve that is supposed to block semen from getting into the bladder doesn't close the way it should. If this valve stays open, semen shoots backward into the bladder instead of out through the penis during a man's climax. This is called retrograde ejaculation. When the problem is just retrograde ejaculation, there are medicines that can be taken for it. If the medicine works, normal ejaculation of semen is restored. The seminal vesicles contract, the internal valve at the bladder entrance closes, and semen is ejaculated from the penis at orgasm. In the United States, the most common medicine used to restore emission is ephedrine sulfate. Because it does not help everyone and may only work for a few doses, ephedrine sulfate is usually prescribed only for the fertile week of the woman's cycle.
Another option for retrograde ejaculation is that live sperm cells can be taken from urine a man produces just after a climax. The man is given medicine to make his urine less acidic, causing less damage to his sperm. Usually the man is asked to use self-stimulation to reach orgasm at the urology clinic. His urine is collected just after orgasm, either through urination or catheterization. The sperm cells are separated and put in a sterile solution to use in infertility treatment.
If none of these options work, another choice is to put a man under anesthesia (drugs are used to put him into a deep sleep) and a special electrical probe is used in the anal canal to trigger an ejaculation of semen through the penis. Since this procedure, called electro-ejaculation, can cause scar tissue to form, it is not used often. It must be done with a special machine that is only available in some infertility clinics.
For Men Who Produce No Sperm
A new procedure called microdissection testicular sperm extraction (TESE) allows surgeons to locate and remove individual sperm from testicular tissue. The sperm can then be injected into eggs that have been clinically removed.
Using donor sperm (donor insemination) is the most simple and least expensive way to become a parent for men who are infertile after cancer treatment. Major sperm banks in the United States collect sperm from young men who go through a detailed screening of their physical health, family health history, educational and emotional history, and even some genetic testing. Sperm donors are chosen for their high sperm counts and motility. They are also tested for sexually transmitted diseases, including the human immunodeficiency virus (HIV) that causes AIDS and the hepatitis viruses B and C. Couples may be able to choose a donor who will remain anonymous or one who will be willing to have contact with a child later in life. Anonymous donor sperm usually costs less.
Insemination usually is done in the doctor's office. The purified sperm sample is placed directly into the woman's uterus through a tiny, flexible tube. If needed, the woman's doctor might prescribe hormones to ripen more than one egg, which will increase the chance of a pregnancy. Success rates are good, and most women under age 35 without fertility problems get pregnant in an average of 3 to 6 cycles. The cost of donor sperm varies, but averages about $500 to $600 a cycle, and includes the cost of the insemination. This cost does not include the cost of hormones for the woman. Be sure to ask for a list of all fees and charges before insemination, since these differ from one sperm bank to another.
