Medical Oncologist
Reproductive health
Fertility, Pregnancy and Contraception — on Abiraterone
Abiraterone gets into semen and can harm a developing fetus. If your partner can become pregnant, contraception is a firm clinical requirement — during treatment and for three weeks after your last dose.
Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed August 2026
- Condom required — If your partner can conceive, you must use a condom every time, during treatment and for three weeks after stopping.
- Second method also needed — A condom alone is not sufficient. Your team will advise on a second contraceptive method alongside it.
- Tablets are also a hazard — If your partner is pregnant, she must not handle your tablets without protective gloves — the drug is absorbed through skin.
- Fertility may be affected — Abiraterone reduces androgen production, which can lower sperm count. Discuss sperm banking before your first dose.
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Abiraterone is harmful to a developing fetus and must never be taken during pregnancy. Since it is used for prostate cancer in men, the key requirement is contraception: if your partner can become pregnant, you must use a condom plus one other method during the whole treatment period and for three weeks after your last dose.
Can your partner become pregnant while you are on abiraterone?
Abiraterone is proven to cause fetal harm in animal studies, and the drug is present in semen — which is why contraception is required even though the person taking it is male.
If your partner can become pregnant, you must use a condom every time you have sex, both during treatment and for three weeks after your final dose. Your team will also advise using one additional contraceptive method alongside the condom.
If your partner is already pregnant, she must not handle abiraterone tablets without wearing protective gloves. The drug can be absorbed through skin.
What is required during treatment versus after your last dose?
| Requirement | During treatment | Three weeks after last dose |
|---|---|---|
| Condom use | Required every time if partner can conceive | Required every time |
| Second contraceptive method | Required alongside condom | Required alongside condom |
| Sperm donation | Not permitted | Not permitted |
| Pregnant partner handling tablets | Protective gloves required | Protective gloves required |
What does abiraterone do to male fertility?
Abiraterone works by reducing the body's production of androgens, including testosterone. Testosterone is needed for sperm production, so treatment can reduce sperm count and sperm quality.
Whether fertility recovers after stopping is not fully established. Recovery is possible in some men, but it is not guaranteed.
If you want to father a child in future, discuss sperm banking before your first dose. Most fertility centres can arrange a sample within a few days, and that window closes once treatment is underway.
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MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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What to do before and during treatment
- Tell your oncologist now if you plan to father a child in future.
- Arrange sperm banking before your first dose if you want to keep that option open.
- Use a condom every time during treatment, even if your partner uses another method.
- Ask your partner to wear protective gloves when handling your tablets if she is pregnant.
- Keep using contraception for the full three weeks after your last dose.
- Tell your team about any changes in sexual health you notice during treatment.
Questions families ask most
What if my partner is already pregnant when I am prescribed abiraterone?
Tell your oncologist immediately. Your partner must not handle the tablets at any point without wearing protective gloves, because abiraterone is absorbed through skin. You must use a condom every time you have sex for the duration of the pregnancy. Your team will also want to discuss whether the treatment schedule needs any adjustment, and they may refer your partner to an obstetrician for additional monitoring. This is not a reason to delay or avoid treatment — it is a reason to manage it carefully.
Can we plan a pregnancy after I finish abiraterone?
The mandatory contraception requirement runs for three weeks after your last dose, according to FDA and EMA prescribing guidance. Beyond that period, there is no fixed regulatory rule — but fertility specialists generally recommend a longer interval before attempting conception, because sperm quality may take more time to recover after hormonal suppression. Discuss the timing with both your oncologist and a fertility specialist before stopping contraception. The right answer depends on how long you were on treatment and how your hormone levels recover.
Does the contraception requirement apply if my partner cannot become pregnant?
If your partner has had a confirmed hysterectomy, bilateral oophorectomy, or is post-menopausal, the fetal harm risk is not present in the same way. Even so, do not assume the requirement is lifted without specifically asking your oncologist. The exemption depends on documented medical confirmation, not on age or assumption. Your team will tell you clearly whether any precaution still applies in your specific situation.
Will my fertility recover after stopping abiraterone?
Possibly, but it is not guaranteed. Abiraterone suppresses testosterone and the androgens that drive sperm production. Once the drug clears and hormone levels begin to recover, sperm count may improve over months. However, the underlying prostate cancer and any prior treatments — surgery, radiation, other hormone therapy — also affect fertility independently, and the picture is rarely straightforward. A fertility specialist can assess your hormone levels and semen analysis and give you a clearer picture based on your own results.
What counts as a second effective contraceptive method?
Your oncologist or pharmacist will advise on the specific options that suit your situation. Common examples include barrier methods, hormonal contraception used by your partner, and intrauterine devices. The requirement is that a condom alone is not considered sufficient, given the seriousness of the fetal harm risk — a second method provides a backup layer. Both methods must be used together, not chosen between. Ask your team to write down the recommended options clearly so you and your partner can decide together.
Did you know?
Abiraterone is present in semen, which is why men taking it — not just their partners — carry the contraception obligation.
FDA and EMA prescribing guidance sets the washout period at three weeks after the last dose before the requirement ends.
Source: Abiraterone acetate prescribing information, US FDA and EMA
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Common questions
Frequently asked questions
How long do I need to use contraception after stopping abiraterone?
Three weeks after your last dose, according to FDA and EMA prescribing guidance. During those three weeks, use a condom and the second contraceptive method your team advised, in exactly the same way as during treatment. After that period, if you and your partner are planning a pregnancy, speak with both your oncologist and a fertility specialist before stopping contraception — sperm quality may need longer to recover than the formal washout period covers.
Can I donate sperm while I am taking abiraterone?
No. Sperm donation is not permitted during abiraterone treatment or during the three-week washout period after your last dose. If preserving fertility is important to you, the time to bank sperm is before your first dose, when sperm quality has not yet been affected by the drug or the hormonal changes it causes.
Does my partner need to do anything about handling my tablets?
Yes, if she is pregnant or could become pregnant. Abiraterone can be absorbed through skin, so a pregnant partner must wear protective gloves any time she handles your tablets — including when helping with medication management. If she is not pregnant and cannot become pregnant, the fetal risk is absent. Either way, the simplest habit is to keep tablets in their packaging and handle them yourself wherever possible.
Is it safe to father a child after the three-week washout?
The three-week washout is the minimum point at which the formal contraception requirement ends — it is not necessarily the right time to attempt conception. Fertility specialists generally recommend a longer interval to allow sperm quality to recover after hormonal suppression. Your oncologist may also want to confirm your disease status before you plan a pregnancy. Speak with both your oncologist and a fertility specialist before making that decision.
Will abiraterone affect my sex life?
It can. Abiraterone reduces androgen levels, and low testosterone commonly affects libido and can contribute to erectile difficulties. These are related to the hormone suppression the drug is designed to produce. Tell your team what you are noticing — management strategies are available, and knowing the cause makes it easier to address. Sexual health is a legitimate part of your care plan, not a question to set aside.
Should we use contraception even if we are not planning children?
Yes. The requirement is not based on your intentions — it is based on the risk if a pregnancy were to occur. Abiraterone causes serious fetal harm, and prescribing rules require contraception regardless of whether conception is planned. The only exception is where pregnancy is not biologically possible, and even then, confirm this with your team rather than assuming.