Fertility managment in testicular cancer: the need to establish a standardized and evidence‐based patient‐centric pathway

Moody, J.A.; Ahmed, Kamran; Yap, Tet; Minhas, Suks; Shabbir, Majid

doi:10.1111/bju.14455

Cited by 52 publications

(54 citation statements)

References 90 publications

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“…In this study, 46.2 % patients with leukaemia and lymphoma had no spermatozoa to freeze. Some reports have shown that leukaemia patients have an innate suppression of spermatogenesis through an unknown mechanism [ 19 – 21 ]. In practice, a few cancer patients visiting our unit give up sperm preservation owing to the cost.…”

Section: Discussionmentioning

confidence: 99%

Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience

Liu

et al. 2021

Basic Clin. Androl.

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Background Sperm cryopreservation, an effective method for preserving male fertility, is very advantageous for men suffering from cancer. Unfortunately, as both physicians and cancer patients are unaware of the possibilities for sperm cryopreservation, the data on evaluation of semen parameters and disposition of cryopreserved samples among Chinese cancer patients are scarce. Results Male tumours were classified into six major types, germ cell tumours (26 %), haematological neoplasms (28 %), head and neck cancers (19 %), thoracic tumours (4 %), abdominal tumours (10 %), and others (13 %). Haematological neoplasm was the most prevalent cancer among our cohort of patients who opted for sperm banking, followed by germ cell tumours. Patients with germ cell tumours had the lowest pre-thaw and post-thaw seminal sperm concentrations. We separately compared patients with testicular tumours, lymphoma, and leukaemia, and found that leukaemia patients had the lowest pre-thaw sperm concentrations. Most cancer patients (58 %) chose to keep their specimens stored, while 31 % chose to discard the specimens. Over the years, only 13 patients (4 %) returned to use their spermatozoa by assisted reproductive technology. Of the stored samples, patients with germ cell tumours constituted the highest proportion (29.3 %). Moreover, the percentage of haematological neoplasm patients who had no spermatozoa frozen was the highest (46.2 %). Conclusions The present data confirm the deleterious impact of various cancers on semen quality. Leukaemia was associated with the worst semen quality and the highest number of semen samples that could not be frozen. We suggest that sperm quality may have decreased even before anti-neoplastic treatment and that sperm banking before treatment should be strongly recommended for cancer patients. A sperm banking programme before gonadotoxic therapy requires close cooperation between assisted reproduction centres and cancer clinics.

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Section: Discussionmentioning

confidence: 99%

Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience

Liu

et al. 2021

Basic Clin. Androl.

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“…There are several causes of semen quality decline before cancer treatment, such as disruption of the blood-testis barrier and endocrine derangements [18,19]. Some studies show that cancer patients especially leukemia patients have an innate suppression of spermatogenesis, but the mechanism for suppression is under studied [15,20,21]. So, not so paradoxically, testicular tumors needing removing one testicle and blood tumor (including Hodgkin's lymphoma, non-Hodgkin's lymphoma and leukemia) causing fever both resulted in lower sperm concentrations than other cancers.…”

Section: Discussionmentioning

confidence: 99%

Sperm cryopreservation of male cancer patients for fertility preservation : 10-year monocentric experience

Liu¹,

Liu²,

liu³

et al. 2021

Preprint

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Background: Semen cryopreservation is an effective method to preserve fertility, which is very important for male cancer patients. Unfortunately, due to unaware of the opportunities for sperm cryopreservation for both physicians and cancer patients, not a lot of data on evaluating the semen parameters and dispositions of the cryopreserved samples of Chinese cancer population are available in the literature. Methods: We retrospectively reviewed semen parameters as well as the clinical outcomes of assisted reproductive treatments (ART) of 339 male cancer patients of Chinese population who were referred to our center from 2010 to 2019 for fertility preservation. Results: We first classify the male tumors into six major types according to body regions. The most prevalent cancer patients who came from our cohort for sperm banking were hematological neoplasms patients, and the second cancers were germ cell tumors. Patients with germ cell tumors had the lowest pre- thaw and post-thaw concentration among the six major cancer types. However, we separately compared among testicular tumors, lymphoma and leukemia, it turned out that leukemia had the lowest pre-thaw concentration. Most cancer patients (58%) chose to go on keeping their specimens in storage. The second proportion selected to discard their specimens electively (31%). Over the years, there were only 13 patients (4%) returned to use their sperm by ART. In the storage samples, germ cell tumors were the most proportion ones (29.3%). Moreover, in the unfrozen samples, the percentage of hematological neoplasms were the most (45.5%).Conclusions: To our knowledge, we had owned the most numbers of male cancers who came to sperm bank for fertility conservation in the southwest of China. In our study we suggested that sperm quality could decrease even before antineoplastic treatment and sperm banking prior to treatment should be strongly recommended for male cancer patients.

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“…79,[82][83][84] Approximately half of the patients with newly diagnosed TC have low sperm counts (,20 million/mL), decreased motility indices (,40%), and large percentages of abnormal sperm cells before receipt of any RT or chemotherapy. 85 A systematic review 86 reported that 6% to 24% of TCS are azoospermic and 50% oligozoospermic at TC diagnosis. Because spermatogonia are highly sensitive to RT, 87 scattered irradiation of the remaining testicle during abdominal RT can adversely affect short-term reproductive function of TCS.…”

Section: Hypogonadismmentioning

confidence: 99%

Testicular Cancer Survivorship

Fung

Dinh

Fosså

et al. 2019

Journal of the National Comprehensive Cancer Network

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Testicular cancer (TC) is the most common cancer among men aged 18 to 39 years. It is highly curable, with a 10-year relative survival approaching 95% due to effective cisplatin-based chemotherapy. Given the increasing incidence of TC and improved survival, TC survivors (TCS) now account for approximately 4% of all US male cancer survivors. They have also become a valuable cohort for adult-onset cancer survivorship research, given their prolonged survival. Commensurately, long-term treatment-related complications have emerged as important survivorship issues. These late effects include life-threatening conditions, such as second malignant neoplasms and cardiovascular disease. Moreover, TCS can also experience hearing loss, tinnitus, neurotoxicity, nephrotoxicity, pulmonary toxicity, hypogonadism, infertility, anxiety, depression, cognitive impairment, and chronic cancer-related fatigue. Characterization of the number and severity of long-term adverse health outcomes among TCS remains critical to develop risk-stratified, evidence-based follow-up guidelines and to inform the development of preventive measures and interventions. In addition, an improved understanding of the long-term effects of TC treatment on mortality due to noncancer causes and second malignant neoplasms remains paramount. Future research should focus on the continued development of large, well-characterized clinical cohorts of TCS for lifelong follow-up. These systematic, comprehensive approaches can provide the needed infrastructure for further investigation of long-term latency patterns of various medical and psychosocial morbidities and for more in-depth studies investigating associated etiopathogenetic pathways. Studies examining premature physiologic aging may also serve as new frontiers in TC survivorship research.

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Fertility managment in testicular cancer: the need to establish a standardized and evidence‐based patient‐centric pathway

Cited by 52 publications

References 90 publications

Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience

Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience

Sperm cryopreservation of male cancer patients for fertility preservation : 10-year monocentric experience

Testicular Cancer Survivorship

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