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Chemotherapy (chemo) works by killing cells in the body that are dividing quickly. Since sperm cells divide quickly, they are an easy target for damage by chemo. Permanent infertility can result if all the immature cells in the testicles that divide to make new sperm (spermatogonial stem cells) are damaged to the point that they can no longer produce maturing sperm cells.

The risk of the chemo causing infertility varies depending on:

The patient’s age. For example, men older than 40 may be less likely to recover their fertility after treatment.
The type of drug(s) used. Some drugs are more likely to affect fertility than others.
The doses of drugs given. The higher the doses of chemo, the longer it takes for sperm production to get back to normal after treatment, and the more likely it is to stop.
After chemo treatment, sperm production slows down or might stop altogether. Some sperm production usually returns in 1 to 4 years, but it can take up to 10 years. If sperm production has not recovered within 4 years, it’s less likely to return.

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