Can You Get a Woman Pregnant After Prostatectomy?
No, natural conception is not possible after radical prostatectomy because the surgery removes the prostate and seminal vesicles, eliminating the ability to produce ejaculate and deliver sperm through normal intercourse. However, biological fatherhood remains possible through sperm retrieval techniques and assisted reproductive technologies 1.
Why Natural Conception Is Impossible
After radical prostatectomy, men develop either:
- Anejaculation (40.2% of cases) - complete absence of ejaculation 2
- Retrograde ejaculation (34.8% of cases) - ejaculate travels backward into the bladder 2
- Severely reduced ejaculate volume - in the minority who retain some antegrade ejaculation 2
The surgical removal of the prostate gland and seminal vesicles eliminates the anatomical structures that produce the majority of seminal fluid, making natural sperm delivery impossible 3.
Fertility Preservation Options
Before Surgery (Strongly Recommended)
All men interested in future fertility should undergo sperm cryopreservation before radical prostatectomy 1. This is the most straightforward and reliable approach:
- Semen banking should be completed before any cancer treatment 1
- Fertility counseling should be part of routine pretreatment appointments 1
- This applies regardless of patient age if future fertility is desired 1
- One documented case achieved successful pregnancy via intrauterine insemination using pre-surgery cryopreserved sperm 1
After Surgery (More Complex)
If sperm was not preserved before surgery, pregnancy may still be possible through:
Surgical sperm retrieval techniques:
- Testicular sperm aspiration (TESA) or testicular sperm extraction (TESE) can retrieve viable sperm directly from the testes 3
- These procedures bypass the need for ejaculation entirely 3
- Retrieved sperm must be used with assisted reproductive technologies (IVF/ICSI) 3
Bladder sperm recovery (for retrograde ejaculation only):
- In cases of retrograde ejaculation, spermatozoa can be recovered from post-orgasmic urine 2, 4
- One case report documented successful pregnancy using bladder-recovered sperm 4
- This technique is only applicable if retrograde ejaculation occurs rather than complete anejaculation 2
Assisted Reproductive Technology Requirements
IVF with ICSI is necessary for post-prostatectomy fertility 3:
- IVF provides approximately 37% live delivery rate per cycle 3
- Success rates decline significantly with increasing female partner age (particularly over 35 years) 3
- Multiple embryo cryopreservation may allow additional pregnancy attempts from a single retrieval cycle 3
Critical Counseling Points
Timing considerations:
- Sperm retrieval and ART planning should occur before surgery whenever possible 1
- Post-surgery options are more invasive, expensive, and have lower success rates than pre-surgery preservation 1
Partner factors:
- Female partner age and ovarian reserve significantly impact success rates 3
- Couples with limited female ovarian reserve should prioritize expedited fertility treatment planning 3
Common pitfall: Many men are not counseled about fertility preservation before prostatectomy, losing the opportunity for straightforward sperm banking 1. This represents a significant gap in preoperative care that should be systematically addressed.