Male fertility after breast cancer treatment

Breast cancer in men is uncommon, but men who are diagnosed may be young enough to want children in future. Treatment can affect male fertility in several ways. Chemotherapy can damage the cells in the testicles that produce sperm, sometimes reducing sperm count temporarily and, depending on the medicines and doses used, occasionally permanently. Hormone therapy, which many men with breast cancer receive because most male breast cancers are hormone receptor positive, can lower sex drive, cause erection difficulties and sometimes affect sperm production. Some men receive medicines that lower testosterone, which can further affect fertility and sexual function. Radiation to the chest does not usually affect the testicles directly. The most reliable way to protect future fertility is to freeze sperm, known as sperm banking, before chemotherapy or hormone therapy begins. It involves providing semen samples at a fertility clinic, which are tested and frozen for future use through intrauterine insemination or IVF. Men who did not bank sperm can have semen analysis after treatment, as sperm production often recovers over months to years. Pregnancy should be avoided during treatment, because medicines can affect sperm, so condoms are advised during and for a period after chemotherapy. Partners, genetic counselling and sexual health support are also important.

Bank sperm early

Ask about sperm banking as soon as possible after diagnosis, before treatment starts.

Use contraception during treatment

Condoms protect partners and prevent pregnancy while on treatment.

Genetic testing matters

Men with breast cancer are often offered BRCA testing, which can affect children and relatives.

Sperm banking is usually quick and straightforward.

Referral

Your oncologist can refer you to a fertility clinic or sperm bank, ideally within days.

Tests

Blood tests check for infections, as required before storage.

Providing samples

Semen samples are produced in a private room at the clinic. Several samples over a few days may be stored if time allows.

Freezing and storage

Samples are analysed, frozen and stored, often for many years.

Costs

Clinics charge for freezing and yearly storage. Ask for a written estimate.

Men with breast cancer have a higher chance of carrying a BRCA2 mutation.

Why testing matters

Results can guide your own care and help relatives understand their risk.

Passing on mutations

Each child has a one in two chance of inheriting a mutation. Genetic counselling explains options, including embryo testing during IVF.

Daughters and sons

Both can inherit the mutation, with different cancer risks.

When your team agrees it is safe, several steps help.

Semen analysis

A test shows whether natural conception is likely or whether banked sperm should be used.

Timing after treatment

Doctors often suggest waiting some months after chemotherapy before trying to conceive naturally, because sperm produced soon after treatment may be affected. Your team will advise on a suitable interval.

Using banked sperm

If sperm counts remain low, banked samples can be used through insemination or IVF. The fertility clinic will explain how many samples are available and the likely chances of success.

Health before conception

Not smoking, limiting alcohol, keeping a healthy weight and staying active can improve sperm quality and overall health while you try for a baby.

Emotional support

Waiting for semen results or fertility treatment can be stressful. Counselling helps couples cope together.

Keep in touch with the clinic

Update the sperm bank with any change of address so storage consent stays current.

Partner assessment

Your partner's fertility is also checked, as conception depends on both partners.