Most men take it for granted that – when the time comes – they’ll be able to father a child. But for men who were treated for childhood cancers, starting a family the traditional way can be a problem.
David Chisholm and his wife, Carly Weiner, of Toronto knew from the time they got married three years ago that they would have difficulty conceiving. As a child, Chisholm was treated for cancer. The chemotherapy and radiation damaged his sperm.
“I thought we would be one of those couples where, oh it was one in a million, we just got pregnant…even though the doctors told us it couldn’t happen,” Weiner said.
The couple, in their early 30s, were told their chances for success through in vitro fertilization (IVF) were fairly good. So far, they’ve been through three IVF attempts with no success.
Recent studies have suggested that infertility in men can also be a risk factor in other more serious conditions. Dr. Thomas Walsh of the University of Washington School of Medicine, says infertility increases the risk of testis cancer three-fold.
In a study published in the journal http://onlinelibrary.wiley.com/doi/10.1002/cncr.25075/full” target=”_blank”>Cancer in March 2010, Walsh and his team found that infertility can also be linked to virulent forms of prostate cancer.
“Specifically those men who were infertile and had abnormal semen quality were about two-and-a-half times more likely to develop high-grade – so clinically significant – prostate cancer.”
The study followed 22,000 men. It also found that the median time from infertility diagnosis to the development of prostate cancer was 10 years. While the study suggested a link between infertility and aggressive prostate cancer, there was no statistical link to low-grade prostate cancer.
Before the study was published, the most established risk factors for prostate cancer were age, family history and race.
Men struggling with infertility can turn to assisted reproductive technology (ART) to improve their odds of success. But there may be risks associated with those better odds.
A California study looked at thousands of women who visited fertility clinics and tracked the health of the babies who were born. Dr. Mary Croughan, an epidemiologist at the University of California, San Francisco, looked for things like ADHD, behaviour disorders and vision and hearing problems – as well as more severe issues like cerebral palsy, mental retardation, autism and seizure disorders.
What she found was disturbing.
“Of the mild outcomes there was about a 60 per cent increased risk in the kids whose either mother, father or both had been infertile at the time they were conceived,” Croughan said. “And in the severe outcomes, there was a four-fold increased risk.”
Outcomes like these are leaving researchers to ask whether the conditions are related to the infertility of the parent or the fertility technologies used to conceive.
“Even a natural conception in the infertile group was still associated with about a three-fold increased risk of the severe outcomes and about a 50 per cent increase in the risk of mild outcomes. And in addition, the higher the technology that‘s needed to actually conceive the pregnancy, the more likely that you are to have some of the adverse neurologic problems afterwards,” Croughan said.
So it may be a bit of both – even though the chances of problems among children born through ART are still quite small. But those risks increase as the number of embryos implanted goes up. The greater the number of implanted embryos, the higher the risk for pre-term and low birth weight babies, who are at higher risk of breathing, heart and vision problems – and a higher chance of lifelong disabilities.
Despite the risks, David Chisholm and Carly Weiner say they’re not ready to give up on their dream to have children.
“I can just picture David cooking for them, teaching them how to cook, and me teaching them baking cookies together… I see my siblings doing that with their kids and I get to do it with my nieces but it’s not the same,” Weiner said.
– With files from Beatrice Politi
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