Fertility preservation of patients with testicular cancer

Abstract

BackgroundTesticular cancer (TC) is one of the most common malignancies in young men of reproductive age. Although TC is a curable malignancy with a high survival rate, its treatment requires various cytotoxic modalities and negatively impacts spermatogenesis; therefore, the fertility preservation of patients with TC has been studied.MethodsIn order to give an overview of fertility preservation in patients with TC, the literature was reviewed. Original and review articles were identified and examined on the basis of PubMed database searches.ResultsChemotherapy and radiotherapy damage spermatogenesis and retroperitoneal lymph node dissection negatively impacts ejaculatory function. Testicular sperm extraction facilitates successful sperm retrieval in patients with TC with postchemotherapy azoospermia. Although preserved sperm is used with a very low frequency (8%), the conception rates in those who have used sperm are not inferior.ConclusionThe number of studies is limited, and because numerous treatment factors affect fertility, outstanding questions remain about preserving the fertility of patients with TC. Further studies are necessary in order to determine the best means of preventing and treating infertility in patients with TC.

Genitourinary cancer patients have worse baseline semen parameters than healthy sperm bankers

“…The etiology for impaired semen quality among sperm bankers with malignancy is unknown. Hypothesized mechanisms include autoimmune, endocrine, and stress-induced effects of cancer, as well as testicular dysgenesis among men with testicular cancer (Williams et al, 2009;Katz et al, 2013;Hamano et al, 2017). While it is beyond the scope of this study to propose mechanisms for the observed differences in semen quality, it is feasible that some or all of these factors may be involved.…”

“…Hypothesized mechanisms include autoimmune, endocrine, and stress-induced effects of cancer, as well as testicular dysgenesis among men with testicular cancer (Williams et al, 2009;Katz et al, 2013;Hamano et al, 2017). Hypothesized mechanisms include autoimmune, endocrine, and stress-induced effects of cancer, as well as testicular dysgenesis among men with testicular cancer (Williams et al, 2009;Katz et al, 2013;Hamano et al, 2017).…”

“…Counseling these patients on their risk of future infertility, and on their options for fertility preservation, is considered standard of care but continues to be an area of needed improvement (Hotaling et al, 2013;Williams, 2013;Hamano et al, 2017). Counseling these patients on their risk of future infertility, and on their options for fertility preservation, is considered standard of care but continues to be an area of needed improvement (Hotaling et al, 2013;Williams, 2013;Hamano et al, 2017).…”

“…As rates of survival among young male cancer patients improve, family planning and fertility preservation for patients with malignancy have become increasingly important. Counseling these patients on their risk of future infertility, and on their options for fertility preservation, is considered standard of care but continues to be an area of needed improvement (Hotaling et al, 2013;Williams, 2013;Hamano et al, 2017). For instance, only a small percentage of men diagnosed with cancer choose to bank spermatozoa, with reported rates ranging from less than 5% to approximately 25%; this deficiency has been attributed in part to inadequate patient education and awareness (Chung et al, 2004;Polland & Berookhim, 2016;Hamano et al, 2017).…”

Differences in semen characteristics between patients with testicular cancer and other malignancies using various cut‐off values

“…TC is one of the leading malignancies in males of reproductive age . Although patients with TC are at higher risk of unfavorable semen parameters than those with other malignancies, the success rates with ARTs in those with TC are reportedly comparable with those with other malignancies . However, it remains unclear which parameters have an impact on outcomes of subsequent ART in cancer patients.…”