By Dr. Oliver Pack (Medical Doctor – Reg. No. 030308944).
Prostate cancer is the most common tumor among men in Spain, with around 35,000 new cases diagnosed annually. This disease typically appears after the age of 50, with a higher incidence in men over 65.
Although prostate cancer is very prevalent in our society, the good news is that it has a survival rate of over 90% at five years when detected early. Therefore, early detection is very important, as it also allows decisions to be made to prevent the disease from affecting male fertility.

The prostate is a gland the size of a walnut located below the bladder, whose main function is to produce part of the seminal fluid that nourishes and transports sperm.
It is important to highlight that prostate cancer itself usually does not directly affect sperm production (which takes place in the testes), but the treatments used to fight it—surgery, radiotherapy, and hormone therapy—can have significant consequences for male fertility.
One of the most common interventions is radical prostatectomy, which involves the complete removal of the prostate and often the seminal vesicles. This surgery generally causes irreversible loss of the ability to ejaculate, preventing sperm from being expelled. In other cases, treatment may include radiotherapy, which can damage the nerves and structures necessary for ejaculation and affect sperm quality if areas near the testes are irradiated.
Finally, the use of hormone therapy to combat prostate cancer can reduce testosterone levels, affecting both sperm production and sexual desire, thus decreasing the chances of achieving pregnancy.
When a man is diagnosed with prostate cancer, especially if he is young or wishes to have children, it is essential to act quickly to preserve fertility. The most recommended option is semen cryopreservation.

This method consists of collecting one or several semen samples before starting treatment and freezing them at very low temperatures for future use. It is a simple and painless procedure (only requiring ejaculation).
In most cases, it is not possible. Radical prostatectomy prevents ejaculation, although the ability to have erections is maintained. In cases where treatment includes radiotherapy or hormone therapy, sperm production can be significantly affected. For this reason, natural conception after prostate cancer is unlikely.
Therefore, it is essential to consider alternatives such as sperm freezing for future assisted reproduction treatments.
Semen preservation allows sperm to be stored in optimal conditions for years, to be used when the couple decides to pursue parenthood. The most suitable treatment will depend on the couple's situation:
In artificial insemination, semen is introduced into the woman's uterus during ovulation and is recommended when there is a good quantity of motile sperm.
The egg is fertilized in the laboratory with viable sperm, and the resulting embryo is then transferred to the uterus. Useful when sperm count or motility is low.
Intracytoplasmic sperm injection or ICSI technique is used in cases with very low sperm count. A sperm is injected directly into the egg to fertilize it, and the embryo is transferred into the woman’s uterus.
At IVF-Life, we have success rates of over 70% in IVF treatments. These rates can increase if combined with preimplantation genetic testing (PGT), which raises the chances of success to 8 out of 10 patients.
However, factors such as the woman’s age or egg quality must always be taken into account. Ideally, a comprehensive fertility study should be performed before starting treatment. Contact us if you have any questions.
According to the latest report published by the Spanish Fertility Society (SEF) with data from 2022, more than 10,000 semen cryopreservation procedures were performed in fertility clinics in Spain, and approximately 12% of these samples corresponded to oncology patients.
Prostate cancer can pose a challenge to male fertility beyond the disease itself. However, with proper planning, fatherhood is achievable after overcoming it. Openly discussing fertility and cancer not only helps make better decisions but also raises awareness about a reality that affects thousands of people every year.