It may take some time for the sperm count to recover. If you have finished treatment by 6 months there should be some sperm present in the ejaculate. Your GP can arrange a test. If the count is normal then the sperm production has returned to normal and there is no need to worry. It is unlikely to deteriorate. If your count is low or absent then you should have a blood test to see is the testes have stopped working permanently. This is a hormone called FSH and it is raised in this situation.
There is some anxiety about DNA damage to sperm production after chemo and radiotherapy. In theory this might result in an increase in the risk of abnormality of any resulting child. Whilst this is possible there is as yet no evidence that this is the case. If you have had sperm frozen before treatment and still are producing sperm our advice is to use fresh sperm whether it is for natural conception or assisted conception.
Chemotherapy and radiotherapy may have profound effects on the ovary. If your periods return after treatment then this is a good sign as is the absence of menopausal symptoms such as hot flushes and night sweats. Radiotherapy usually has a more profound effect on ovarian function. If you have no periods 6 months after treatment arrange an FSH Blood test. If raised it is likely that your ovaries have been permanently damaged by the treatment and will probably not recover. Late recovery does happen but is rare.
If your periods return and tests say you are ovulating then this is a very good sign. Your fertility has probably returned to its pre-existing status.
If you are not planning immediate conception then tests of ovarian reserve may give important information as to how long your ovaries will keep working. It might be that there will be no adverse effect and the ovaries will keep working until they would have ceased naturally. Alternatively treatment may have destroyed a portion of the ovary. Tests of ovarian reserve are FSH, done in the first 5 days of the cycle, anti mullerian antibody test (blood test) or antral follicle count measured by ultrasound.
The fertility service will be happy to discuss the implication of any test and the result of any test you have had. To arrange an appointment see - how to get a referral