Dear Sarah,
If you can visit with a male fertility specialist, they will be able to assess your husbands fertility potential. Chemotherapy can impair a man’s sperm production in the testicles, and you have done the research to know that surgery near the spine may have affected the nerves responsible for ejaculation. A physical exam, hormonal profile and a semen analysis is a great way to start:
Physical exam: If the testicles are dramatically smaller than normal, then that would suggest that the testicles may be impaired from the chemotherapy since 80% of the testicular volume is dedicated to sperm production.
Hormonal profile: If the Follicle-stimulating hormone (FSH) is elevated (approximately >7.5), then this would also be suggestive that the testicles are not working properly. Have them also check a testosterone level, Luteinizing hormone and estradiol to complete the evaluation.
Semen analysis: If the volume is very low (<1.5mL)with little or no sperm, have them check a urine sample right after ejaculation called a Post-Ejaculate Urine to look to see if he is ejaculating backwards into the bladder which would be called retrograde ejaculation. Please note that after spine surgeries, some men are unable to ejaculate which is called anejaculation.
These are some preliminary steps you can take to learn more about his fertility status. If you need to, a testicular biopsy (a minor office procedure) would also be able to shed light on the situation to see if there are sperm being made in that spot that is being biopsied.
Hope this helps you get started on your fertility journey.
If we can help, give us a buzz.
Thinking of you.
Dr. K
