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Options for Men Before Treatment
What are the options for men prior to treatment?
The best way for men to preserve their reproductive potential at this point is to cryopreserve (freeze) and store semen. In the past, this was not always a good option because many men with cancer have sperm counts that are less than normal. However, now with in-vitro fertilization and ICSI (intracytoplasmic sperm injection) even very small numbers of sperm can be used to establish a pregnancy.
In order to cryopreserve sperm, the man must be able to produce a semen sample, generally by masturbation. Fairly young men/teenagers should be able to produce a specimen suitable for cryopreservation, but in younger men, the subject can be difficult to bring up or discuss. The semen needs to be delivered promptly to a lab capable of freezing it properly. Ideally the semen sample would be collected right there in the lab. Most labs have a small private room available for this purpose.
If possible and if time permits, several semen specimens should be cryopreserved at intervals of 2 to 3 days. Most men can delay treatment for several days or a week for this purpose.
Shielding the testicles from radiation:
If radiation to the pelvis is part of the treatment plan, a patient and his physician may want to discuss the possibility of shielding the testicles from the radiation. Cure of the cancer is, of course, the most important consideration, so sometimes it will not be possible to shield the testicles and adequately treat the cancer.
In some experimental settings, pieces of testicular tissue from young boys have been cryopreserved in the hope that the tissue might produce sperm in a laboratory culture one day or that the tissue can somehow be returned to the testicle and function.