Effects of oncological treatments on semen quality in patients with testicular neoplasia or lymphoproliferative disorders

Abstract

Pretherapy sperm cryopreservation in young men is currently included in good clinical practice guidelines for cancer patients. The aim of this paper is to outline the effects of different oncological treatments on semen quality in patients with testicular neoplasia or lymphoproliferative disorders, based on an 8-year experience of the Cryopreservation Centre of a large public hospital. Two hundred and sixty-one patients with testicular neoplasia and 219 patients with lymphoproliferative disorders who underwent chemotherapy and/or radiotherapy and pretherapy semen cryopreservation were evaluated. Sperm and hormonal parameters (follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, inhibin B levels) were assessed prior to and 6, 12, 18, 24 and 36 months after the end of cancer treatment. At the time of sperm collection, baseline FSH level and sperm concentration were impaired to a greater extent in patients with malignant testicular neoplasias than in patients with lymphoproliferative disorders. Toxic effects on spermatogenesis were still evident at 6 and 12 months after the end of cancer therapies, while an improvement of seminal parameters was observed after 18 months. In conclusion, an overall increase in sperm concentration was recorded about 18 months after the end of cancer treatments in the majority of patients, even if it was not possible to predict the evolution of each single case 'a priori '. For this reason, pretherapy semen cryopreservation should be considered in all young cancer patients.

Do malignant diseases affect semen quality? Sperm parameters of men with cancers

“…Bizet et al (2012) observed a significant lower total sperm count in patients with TC than that in patients with OC; all median parameters for each cancer type were in the normal WHO 1999 range, except for progressive motility. Two Italian studies showed the pre-freeze semen parameters were not impaired in the testicular neoplasia or in lymphoproliferative disorders (Gandini et al, 2003;Di Bisceglie et al, 2013). On the contrary, van Casteren et al (2010) showed, in 764 patients with different malignancies, that most male patients with cancer were at increased risk of an impaired semen quality; almost twothird of all semen samples was abnormal according to the reference values of the WHO guidelines 1999 (except brain tumours and non-Hodgkin lymphomas).…”

“…Although the deleterious effects of chemotherapy and radiation are well documented (Trottmann et al, 2007;Diedrich et al, 2011), controversies exist about the effect of cancer itself on semen parameters before treatment. Most of the available studies do not consider the different types of cancers and mainly focused on testicular cancers and Hodgkin's disease, and data are heterogeneous and lack of comparison with men healthy and fertile.…”

Role of melatonin in mitigating chemotherapy-induced testicular dysfunction in Wistar rats

“…Spermatogenesis is often impaired in testicular cancer patients prior to chemotherapy as a result of cancer itself (Di Bisceglie et al, 2013). In addition, PVB chemotherapy has substantial detrimental effects on spermatogenic function; most patients remain azoospermic or oligozoospermic for prolonged periods or are rendered permanently infertile (Schrader et al, 2002).…”

Time and Dose-Dependent Effects of Viscum Album Quercus on Rabbit Spermatozoa Motility and Viability in Vitro

“…In the many years, following the increased success rate of cancer treatments, great efforts have been made to improve quality of life in survivors, including fertility preservation in young patients (Masopotova et al 2018). Because of their gonadotoxic effects, chemo-and radiotherapy can temporarily or permanently compromise fertility (Di Bisceglie et al 2013). Oncological treatments present severe gonadotoxic effects on both germ and Leydig cells.…”