Generally when I tell people I had testicular cancer when I was in my mid-twenties, they have a tendency to ask if I am still able to have children. While this seems like a bold choice to immediately inquire about a basic stranger’s fertility, I just have assumed that it means they can see what a natural father I am and that it would be a shame to keep a future child from having me as a dad.

While I’ve been able to theoretically answer that question, I can now definitely say yes, I am able to father a child. The Birckbichler family will be gaining another girl in November, putting the males (two humans and one cat) behind the females (two humans, one cat, and one dog). Today, I’m sharing about the actual mechanics of conceiving (not necessarily going thaaaat in depth), but when Baby B arrives, I’m planning to do a reflection on what it means to me to bring new life into the world.

I would be remiss in not reminding everyone that I am not a medical doctor and most of this post will be based on common questions I’ve received and my own experiences (so Mom, please stop reading here). 

What was your sperm count like before cancer as compared to after cancer?

As I shared before, I did bank sperm prior to beginning chemotherapy. According to my test results back then, I had a total sperm count of 182 million, with a concentration of 38 million per milliliter. A total sperm count of 39 million in one sample is considered to be the “minimum” for a “normal” range.

In 2019, I tried out the Dadi at-home fertility testing kit and discovered that I had a total count of 52 million, with 13.8 million per milliliter concentration. While those figures are lower than my pre-cancer numbers, they are still within a normal range. I haven’t done any further testing since 2019, but my wife’s baby bump shows that clearly I am still fertile. It only takes one! (Feel free to interpret that as either one testicle or one sperm.)

fatherhood after testicular cancer justin birckbichler

Advocate Justin Birckbichler

Having one testicle doesn’t have a huge impact on fertility; however, cancer treatments can possibly lower fertility. Chemotherapy and other treatments can cause infertility for men. Usually this is on a temporary basis, but sometimes it can become permanent. That being said, roughly 80% of those who had similar treatments to me returned to normal fertility within five years.

Did it take longer than “normal” to conceive?

According to various studies, it takes the majority of couples up to a year to successfully conceive. In our case, we began trying in January and had our first positive test in March. This is obviously much quicker than taking a whole year… I am very aware this sets my wife up for a joke saying that it’s not just conceiving that I am fast at.

While my own success rate is sitting at 100% so far, according to one study (link the study again), 85% of testicular cancer survivors who solely had surgery were able to father a child, and those who had chemotherapy were able to penetrate the ovarian fortress in 71% of cases.

Did you have to use IVF or anything like that?

The short answer to this is no, we did not need any medical assistance in conceiving. The longer answer is that we made a baby the natural way. If you don’t understand what the natural way is, go ask your parents what that means, but knock on their door first in case they are in the process too.

This is actually pretty typical for testicular cancer survivors. Of the couples who were able to conceive, 77% were able to do it (pun intended) themselves. 

Have you experienced erectile dysfunction after testicular cancer?

While I have had days where Private Birckbichler hasn’t fully reported for duty, I don’t think that’s a result of cancer as much as other factors in life, including stress, physical exhaustion, and others. 

Research found that “42% of testicular cancer survivors had decreased sexual activity, 35% had decreased libido, and 32% had erectile dysfunction. However, it was determined that these were all more related to psychological factors versus physical reasons. It’s almost like dealing (or choosing to not deal) with a life-changing diagnosis in your pants has an impact on your mental health. Who knew?

My final thoughts on conceiving after testicular cancer

If you’re looking to have children after going through cancer, I say go for it (once you are medically able to). Best case scenario, the stork will bring a baby to your family. Worst case, you get to have a lot of fun “quality time” with your partner and have to explore other options to become a dad.

On a serious note, I recognize that I am very fortunate that our conceiving process has been relatively easy and we’ve been having a healthy pregnancy thus far. There are plenty of resources out there for couples who may experience challenges, like this list from the National Cancer Institute and the Band of Ballers alum Michael Scherer’s work with Worth The Wait.

This post originally appeared July 2, 2023, on A Ballsy Sense of Tumor. It is republished with permission.