Lance Armstrong may be the poster child for proving that cancer doesn’t have to mean the end of baby-making for guys. The world-renowned cyclist owes his three children to sperm samples preserved before he underwent cancer treatment.

But for too many men, a cancer diagnosis means exactly that. An article in the journal Cancer found that during the decade that ended in 2005, only 18% of 821 young, male cancer patients had chosen to freeze samples of their sperm before undergoing treatment. Experts say the problem is that amid the terror of a cancer diagnosis, the only immediate concern too often is survival.

Both radiation and chemotherapy treatment for cancer can impair sperm production, sometimes severely. The closer radiation treatment is to the testicles, the higher the risk of infertility. In general, the higher the dose and the longer the treatment, the greater the chance for reproductive problems. Your age, the type and dose of drugs, the location and dose of radiation, the scope and location of surgery, your pre-cancer fertility status, and other factors can influence your risk.

Removal of one or both testicles due to cancer also may affect male fertility, too. Of the 35,000 young men diagnosed with cancer each year, about 90% risk losing their fertility to chemotherapy, radiation or surgery. As one doctor described it, sometimes sperm are the innocent bystanders when it comes to cancer treatment.

Your options

The only good news is that it is much easier to preserve male fertility in men than it is women. Men anticipating cancer treatments will frequently make several treatments to the sperm bank before undergoing toxic treatments. The Cancer journal reported that of those young men who tried using their specimens for procreation, 36.4% succeeded with intrauterine insemination and 50% succeeded with two more-expensive techniques — in-vitro fertilization and intracytoplasmic sperm injection.

Visit a urologist or reproductive endocrinologist

Your oncologist may be wonderful, but may not have much experience in considering fertility preservation, if most of his patients are retired. Getting a second opinion on your options may help give you peace of mind.

Local Sperm bank

Visiting a local sperm bank means being handed a container and sent to a closet or bathroom to masturbate and ejaculate in a cup. It’s embarrassing and can be difficult to perform on cue. Depending on how far away from the sperm bank you live, you may be able to create a sample from home and bring it in.

Don’t get too discouraged if it takes lots of trips. With the stress involved in a cancer diagnosis, more than one man has had to make repeated sperm banks visits to successfully make a sample. Ideally, three to five specimens are usually adequate. It costs about $500 to $1,000 to freeze three specimens and about $200 per year for storage. Insurance coverage for cryopreservation of sperm varies tremendously.

Online Resources

American Cancer Society (ACS)

The ACS is a nationwide, community-based voluntary health organization. Headquartered in Atlanta, Georgia, the ACS has state divisions and more than 3,400 local offices. (800) ACS-2345 www.cancer.org

Fertile Hope

Fertile Hope is a national, nonprofit organization dedicated to providing reproductive information, support and hope to cancer patients and survivors whose medical treatments present the risk of infertility. P.O. Box 624, New York, NY 10014, (888) 994-HOPE, www.fertilehope.org