Sexuality & fertility

What impact?

It is normal to be concerned about sexuality when you are diagnosed with testicular cancer. The testicule is associated with the ability to father children, masculinity and testosterone, the hormone responsible for sexual desire!

Might as well address your top-of-mind question: Testicular cancer will have no direct effect on erectile function.

In a sexual context, fear of failure and anxiety can be associated with the fear of not having an erection, the fear of not meeting your partner’s expectations or the fear of not being a good lover. As a result, all such fears will have an effect on an erection. It is therefore not testicular cancer that is the cause, but rather the psychological impacts associated with the performance anxiety associated with this type of cancer!

The type of cancer, where it is located and how it has spread will determine its impact on the quality of your sex life. In the majority of cases, changes in sexual function, should they occur, will disappear over time. The sexual desire phase may be affected by the disease. In the majority of cases, disease related stress, depression and anxiety will contribute to a decrease in sexual desire and a loss of interest in sexual intimacy.

Although rare, some therapies could modify orgasm. Anejaculation, retrograde ejaculation or a decrease in ejaculate volume may be observed.

In any cancer context, talking about one’s sex life may constitute an additional challenge. Several people will tend to turn in on themselves rather than share their concerns about sexuality with their partner.

Such consequences are not the result of testicular cancer, but rather of the psychological impacts associated with performance anxiety.

Sexuality & fertility


When it comes to testicular cancer, there is a lot of nonsense out there.
Careful! Certain myths can add to misconceptions about sexuality and cancer. They are harmful to intimacy and to sexual activities. Here are but a few: 

  • Sexual relations after therapy promote the recurrence of cancer.
  • Cancer can be transmitted to one’s partner.
  • Cancer will put an end to my love life.
  • Sick people have no sexuality.
  • Cancer causes erectile dysfunction.


Sexual relations after therapy promote the recurrence of cancer.

No. Cancer cannot be transmitted to one’s partner during sexual relations. Cancer is not a contagious disease like a cold or the flu.

However, some treatments like chemotherapy require that you take certain precautions such as using a condom for a few days (at least 4 days). Chemotherapy drugs are eliminated through bodily fluids like sperm, urine and sweat. Your partner could come into contact with these fluids.


Cancer can be transmitted to one’s partner

No. Cancer cannot be transmitted to one’s partner during sexual relations. Cancer is not a contagious disease like a cold or the flu.

However, some treatments like chemotherapy require that you take certain precautions such as using a condom for a few days (at least 4 days). Chemotherapy drugs are eliminated through bodily fluids like sperm, urine and sweat. Your partner could come into contact with these fluids. 


Cancer will put an end to my love life.

As a general rule, a stable couple relationship has the necessary resources to get through the cancer journey. Communicating sexual expectations and needs will provide solutions to a satisfactory sexual life. Moreover, sexual intimacy is the result of relational intimacy where mutual respect, tenderness and esteem between partners is an integral part of the relationship. Learning to work as a team, accepting a partner’s influence, not taking small signs of affection for granted and helping each other, respecting the other’s opinion and problem solving through compromise are all elements that contribute to maintaining a satisfactory relationship. The main objective of a couple is to create an atmosphere that encourages each partner to speak honestly about his or her convictions, needs and expectations in order to reach a compromise that is satisfactory to both.

There is no bad time, nor is there a good time, to raise the issue of sexual side effects with a potential partner.

Sexuality & fertility

Addressing the issue

This diagnosis upsets one’s life in more ways than one, and sexuality ranks right up there. Being able to express your feelings, or to share your expectations and your needs with regards to sex could help you find solutions to improve intimacy and sexual relations.

Some questions may prove useful in identifying your needs and make it easier for you to share.

  • What is most important to me when it comes to my sex life?
  • What is most important for my partner?
  • What would be desirable and realistic for the two of us and would allow us to regain a satisfactory sex life given the side effects of the disease?

There is no good time, no bad time to raise the issue of side effects on sexuality with a potential partner. You simply have to feel comfortable and choose the right moment, usually a calm moment, in a relaxed environment.

The impact will depend on your attitude. Generally, testicular cancer should not affect your sex life or impact a potential relationship. Cancer is not the main cause of rejection. No one is fully protected from rejection. There are all sorts of reasons why a person you may be attracted to is not interested in you. Your own interest in that person is also based on several factors.

It is normal to be concerned about a first sexual encounter regardless of whether or not you have had cancer. Making a good impression and meeting expectations can be at the root of performance anxiety.

There are many ways of decreasing your concerns about that first date; take the time you need, be patient and realistic and create an atmosphere that will be conducive to establishing emotional attachment.

It is important that you not seek advice from incompetent people or from unofficial websites promising to solve sexual problems. Other than consulting your doctor, consulting a specialized sexologist can be very helpful.

Websites as well as certain boutiques overflow with all sorts of products that claim to cure or solve certain sexual problems. These products can prove to be dangerous and harmful to your treatments or medications. Before taking any such products, you must be careful and discuss this with your health care team.

Source: Texte rédigée par une sexologue spécialisée en oncologie de l’équipe interdisciplinaire suprarégionale d’uro-oncologie du CHUM, 2014.

Sexuality & fertility

Preserving your fertility

There have been great improvements and breakthroughs in the treatment of cancer among teens and young adults, and these have led to an increased cure rate. While just hearing about therapies is difficult, it is also hard to think about the future at such times, but it is important that you do think about it. Being able to father children is a real concern for patients with testicular cancer. It is essential that patients learn how to preserve their fertility prior to beginning their treatments.

Cancer treatments can mean surgery, radiation therapy and /or chemotherapy. They aim to kill cancer cells and avoid, as far as possible, destroying healthy cells. Treatments can alter reproductive functions and lead to a temporary or permanent loss of fertility.

The risk of becoming sterile depends on the therapy, its duration and the doses used. In fact, this varies enormously from one individual to another. The risk depends on the stem cells’ (the ones that produce sperm) tolerability to the treatment(s). Regular long-term monitoring of sperm once your treatment is finished will help assess sperm production evolution.


What is Sperm Banking?

Storing sperm is an effective way of preserving male fertility. Introduced in the 1970’s, this technique consists in harvesting a patient’s sperm prior to any exposure to toxic cancer therapies and freezing it for future use.

Thanks to the evolution of medicine and reproduction biology, it is possible to preserve the fertility of patients prior to the onset of cancer treatments. Oncofertility is the field of medicine involved in the preservation of fertility among cancer patients.

Freezing and storage of sperm is an available option and is often effective for young teens and adult men.

Beginning the process of preserving fertility is recommended prior to chemotherapy, radiation therapy  and/or surgical interventions in order to preserve good quality sperm. Labs that are experienced in this type of harvesting are able to do so in emergency situations, even a few days before treatment is begun.


How is sperm harvested?  

 All patients wishing to preserve their fertility must make an appointment with a lab authorized to store and freeze sperm.


  1. Preliminary consultations
    During hospital or clinic consultations, patients can obtain information on the storage and use of their sperm. They are required to sign a consent form that lays out storage terms.


  1. How sperm is harvested
    Sperm is harvested through self-masturbation in a dedicated room and is then sent to the lab. Whenever delays allow, it is recommended that patients abstain from having sexual relations for 2 or 3 days prior to harvesting. It is also recommended that several harvests be done to ensure sufficient amounts of sperm if, of course, time allows.Should sperm harvesting be impossible, or in certain specific cases (marrow involvement, paraplegia, non-effective masturbation) other techniques such as vibromassage or electrostimulation can help retrieve sperm. Moreover, there is a surgical procedure that will allow the retrieval of sperm directly from the epididymis (Microscopic Epididymal Sperm Retrieval called MESH) or from the testicle (Testicular Sperm Extraction called TESE).


  1. Sperm analysis
    Retrieved sperm is analysed to verify various parameters: volume collected, sperm concentration, normal sperm morphology, sperm motility. A serological analysis is also required prior to freezing the sperm sample.Should the analysis reveal that the sample quality is unsatisfactory, it may be necessary to obtain a second sample in order to maximize the chances of successful freezing.


  1. Freezing the sample
    The retrieved sample is prepared and treated with cryoprotective agents before being processed. It is then frozen through a process in which the temperature is progressively decreased to -196°C (temperature at which all known cellular biological functions cease). Finally the sample is preserved in liquid nitrogen and safely stored until it is to be used.


How long can samples be stored? 

Once frozen, sperm can be stored as long as the patient desires; there will be no changes in its ability to fertilize.  .

Patients must re-confirm their wish to preserve, or not to preserve samples. They can, at any time, put an end to the process of conservation at which time the samples will be destroyed, or should the agree, used for research purposes.


How much does it cost to retrieve and store sperm samples? 

For Québec residents, costs associated with freezing the sperm of a man who must undergo treatments that can harm his production of sperm are covered by the provincial assisted procreation program. These public services are available free of charge in hospitals and private clinics.

To learn more, visit the Santé Québec website.

This is not covered in the rest of Canada and prices are set independently by clinics. To learn about the rates, we suggest that you communicate with a clinic that is specialized in the treatment of infertility.


Where do I go to have my sperm retrieved to preserve my fertility prior to my treatment? 

There are several centres that provide sperm retrieval and storage services:

Sexuality & fertility

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