Gonadal damage and options for fertility preservation in female and male cancer survivors

Abstract

It is estimated that in 2010, 1 in every 250 adults will be a childhood cancer survivor. Today, oncological surgery, radiotherapy and chemotherapy achieve relatively high rates of remission and long-term survival, yet are often detrimental to fertility. Quality of life is increasingly important to long-term survivors of cancer, and one of the major quality-of-life issues is the ability to produce and raise normal children. Developments in the near future in the emerging field of fertility preservation in cancer survivors promise to be very exciting. This article reviews the published literature, discusses the effects of cancer treatment on fertility and presents the options available today thanks to advances in assisted-reproduction technology for maintaining fertility in male and female patients undergoing this type of treatment. The various diagnostic methods of assessing the fertility potential and the efficacy of in vitro fertilization (IVF) after cancer treatment are also presented.

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

“…5,6 Indeed, oncological treatments present severe gonadotoxic effects on both germ and Leydig cells. [7][8][9] Of note, in a significant percentage of patients (20%-50%) spermatogenesis is impaired even before cancer treatments, probably due to the malignancy itself. 10 The recovery of normal spermatogenesis after treatment may require several years, and mainly depends on three factors: initial sperm count, type and dose of specific oncological treatments and patient age.…”

Human Ovarian Tissue Cryopreservation as Fertility Reserve

“…This information is important for a correct strategy of fertility preservation before cancer treatment. In general, ovarian reserve tests are either biochemical or biophysical (Maltaris et al, 2006), but new methods are required.…”

Potential Risk of Radiotherapy on Fertility among Male Cancer Survivors

“…The seminiferous tubules contain the germ cells, which consist of stem and differentiating spermatogonia, spermatocytes, spermatids and sperms, and the Sertoli cells, which support and regulate germ cell differentiation [3].…”