Fertility of testicular cancer patients after anticancer treatment – experience of 11 years (original) (raw)
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Fertility after testicular cancer treatments
Cancer, 2004
BACKGROUND. Patients with testicular cancer have an excellent survival rate, and fertility is one of the main concerns of survivors. The authors investigated fertility status after treatment for testis cancer in long-term survivors.
The Scientific World Journal, 2014
Aims. In this study we report our results with storage of cryopreserved semen intended for preservation and subsequent infertility treatment in men with testicular cancer during the last 18 years. Methods. Cryopreserved semen of 523 men with testicular cancer was collected between October 1995 and the end of December 2012. Semen of 34 men (6.5%) was used for fertilization of their partners. They underwent 57 treatment cycles with cryopreserved, fresh, and/or donor sperm. Results. A total of 557 men have decided to freeze their semen before cancer treatment. Azoospermia was diagnosed in 34 men (6.1%), and semen was cryopreserved in 532 patients. Seminoma was diagnosed in 283 men (54.1%) and nonseminomatous germ cell tumors in 240 men (45.9%). 34 patients who returned for infertility treatment underwent 46 treatment cycles with cryopreserved sperm. Totally 16 pregnancies were achieved, that is, 34.8% pregnancy rate. Conclusion. The testicular cancer survivors have a good chance of fathering a child by using sperm cryopreserved prior to the oncology treatment, even when it contains only limited number of spermatozoa.
Cancer in addition to the correlated radiotherapy, along with chemotherapy, possess significant deleterious actions on the male reproductive capacity, resulting in a lot of men infertile. Fertility preservation has become a critical issue with regards to survivors in the last 2 decades,with a lot of professional organizations, have published literature with regards to the guidelines that advocate fertility preservation to assume a routine part of dealing with an man who is supposed to receive cancer treatment.Maximum males possess the capacity of generation of an ejaculate having sufficient semen specimen for fertility preservation by cryopreservation of sperms.Despite different other approaches for collection ofsperms are existent certain patients like adult males with azoospermia ,besides, prepubertal, boys who do not have the initiation of spermatogenesis,one cant harvest the sperms ,besides all the advances of cryopreservation of testicular tissue cryopreservation,yet translation to adult sperms has not got attained with lot of efforts being directed towards attaining same by particular metabolism manipulation o fimmature germ cells,besides use of variousfactors like VEGF &PDGF laden nanoparticles .Thus lot of experimental ,besides investigational strategies, give the hope that translation to Clinical scenario that will provide extra pathways In achieving successful fertility preservation. Key Words; Cancer; fertility preservation; cryopreservation of sperms;infertility 1.Introduction The incidence, of cancer has escalated markedly,which represents a heterogenous disorder with about 50% of men generating over their lifetime.In the form of a disease event cancer in addition to treatment of the same might result in battling with a lot of side actions. Dysfunction In the reproductive health being one of these harmful actions, that is associated with infertility,is what these men will usually encounter,besides marked stress ,depression ,anxiety in addition to poor quality of life [1,2]. Secondary to that fertility has become a significant issue that gets correlated with the subjects who survive in this oncology field over the span of the last 2 decades.in this article subsequent to our initial review of fertility preservation advances,that was inclusive of testicular tissue transplantation along with in vitro Spermatogenesis in case of animals,with minimal human experiences, besides, VSELs here we have tried to update the influence of cancer on male fertility preservation,that is inclusive of,the influence of cancer therapies on male fertility,advocated guidelines,results derived from the cryopreservation of sperms from patients with cancer, besides discussion of the stem cell technology that might create a revolution in the field of reproductive medicine[3,4].With the fast pace in clinical along with basic sciences details on fertility preservation this would be of use to clinicians, in addition to those from laboratory besides basic science researchers. Methods
Impact of cancer and cancer treatment on male fertility
HORMONES, 2015
While cancer, and especially testicular cancer and Hodgkin's disease, affects male fertility in many ways, the current increase of survival of male cancer patients of reproductive age or earlier has emerged as a new challenge to their subsequent ability to father children. Cancer treatments, including surgery, radiotherapy and chemotherapy, can have a transitory as well as a permanent detrimental impact on male fertility. Gonadotoxic effects and the length of time for sperm recovery after radiotherapy depends not only on initial semen quality, but also on gonadal dosage and the delivery method after chemotherapy, on the type of regimens and dosages and on the spermatogenesis phase that each drug impacts. Combination treatment with radiotherapy and chemotherapy will induce more gonadotoxicity than either modality alone. Although efforts to prevent gonadal toxicity in cancer treatment are routinely applied, sperm cryopreservation remains the gold standard to maintain male fertility after cancer survival. Fertility preservation for prepubertal boys presents the greatest problem due to the absence of mature sperm in their gonads. In this area, research efforts are concentrated on cryopreservation of immature gametes and, in particular, techniques for their maturation and proliferation after thawing.
Therapeutic Advances in Medical Oncology, 2016
Background: Anticancer treatments can impair male fertility. Cryopreservation of semen is an efficient procedure for fertility preservation. The aim of this study was to evaluate pre-freeze semen parameters among the various types of cancer, post-thaw sperm viability and reproductive outcome of samples used for assisted reproductive treatment (ART). Methods: This study included 721 men with cancer that had their semen cryopreserved in our bank in 1999–2015. Semen analysis and cryopreservation were performed before the start of antineoplastic treatment, according to the World Health Organization recommendations, European Commission and Italian law. Results: Among the 721 patient, 196 had seminoma of the testis, 173 Hodgkin’s lymphoma, 108 mixed testicular tumors, 89 germ cell tumors, 67 other tumors, 46 hematological tumors, and 42 non-Hodgkin’s lymphoma. The mean age of patients was significantly lower in Hodgkin’s lymphoma compared to other tumors. Statistically significant lower v...
Fertility in testicular cancer patients: a single-centre study in Turkey
International Journal of Clinical Oncology, 2019
Background Testicular cancer is a rare type of cancer in males. Since the disease is seen in young men and long-term survival is ensured following a high treatment success rate, fertility in testicular cancer patients is much more important. Prior to commencement of cancer treatment, patients are given counselling with regard to infertility and sexual function, and sperm banking is commonly carried out. The aim of this study was to assess the fertility status prior to and following treatment of monitored testicular cancer patients whose treatment had been completed. Methods 110 patients diagnosed with and treated for testicular cancer at the Medical Oncology Clinic at Akdeniz University during the years 2000-2016 were evaluated for the study. The patients' disease and treatment information was obtained from their records. The patients' characteristics and fertility statuses were determined by means of interviews with the patients. Results The median age of the patients was 36 (20-73) and 39.1% of them (n = 43) were aged between 30 and 39. The average length of follow-up was 6.20 ± 3.36 (2-17) years. It was determined that 42.7% of the patients had banked sperm following diagnosis and that 74.5% of them had received counselling. Following treatment, 33 patients (30%) fathered children. The average time taken to father children after treatment was 3 years. Conclusion In testicular cancer patients, fatherhood is achieved spontaneously or with the cryopreservation process. Counselling plays an important role at the time of diagnosis. It is essential that health professionals in oncology clinics give counselling about fertility in testicular cancer.
Frontiers in Oncology, 2021
Progress in oncological treatment has led to an improved long-term survival of young male cancer patients over the last decades. However, standard cancer treatments frequently implicate fertility-damaging potential. Cryopreservation of sperm is the current standard option to preserve patient’s fertility after treatment, yet long-term data on usage and reproductive experiences is still limited. Natural fertility after treatment and especially in relation to the type of treatment has been poorly analyzed so far. Therefore, we performed a retrospective survey including male patients with an indication for gonadotoxic treatment who cryopreserved reproductive material at our institution between 1994 and 2017. Study questionnaires regarding treatment, material usage, and reproductive outcomes were sent to eligible patients. Additionally, semen analyses of study participants from the time of cryopreservation were evaluated. A total of 99 patients were included in the study. Respondents’ me...
“Reemphasizing the Significance of Fertility Preservation in Cancer Patients Needing Chemotherapy and/or Radiotherapy - A Case Report"., 2024
Introduction With the greater advancements in field of survivors treatment, the survival rates have escalated remarkably, thus the need arising for the fertility preservation in the survivors with regards to oocyte/embryo/ovarian tissue/Cortical tissue/testicular tissue transplantation/sperm cryopreservation has assumed great importance particularly for those receiving chemotherapy that too with alkylating agents. Earlier we have extensively detailed however still we come across akin patients who never received any counselling keeping longterm fertility in mind. The case report we present here highlights this issue. Here we present a case report of how a couple presented With a previous child having diagnosis of type II Arnold Chiari malformations. Later husband gave history of certain axillary mass which was surgically removed in addition to got chemotherapyx 6 cycles and radiotherapy for4 cycles although the nature of chemotherapy was not known he later told diagnosis was non Hodgkin’s lymphoma. Despite his semen parameters were normal 10 years subsequent to chemotherapy and radiotherapy couple was not willing to go for Intracytoplasmic sperm injection (ICSI) with blastocyst transfer subsequent to preimplantation embryo genetic testing (PGT) for aneuploidy (PGT-A), and particular congenital abnormalities. Thereby here we re emphasize the role of counselling for sperm cryopreservationor testicular tissue preservation as per age prior to administration of chemotherapy and radiotherapy for cancer treatment
Contemporary and future insights into fertility preservation in male cancer patients
In recent years, survival rates of cancer patients have increased, resulting in a shift of focus from quantity to quality of life. A key aspect of quality of life is fertility potential; patients suffering from iatrogenic infertility often become depressed. Since many cancer therapies—chemotherapy, radiotherapy and/or surgery—and even cancer itself have detrimental effects on the male reproductive system, it is important to preserve fertility before any treatment commences. Currently, the only reliable method of male fertility preservation is sperm banking. For patients who are unable to provide semen samples by the conventional method of masturbation, there are other techniques such as electroejaculation, microsurgical epididymal sperm aspiration and testicular sperm extraction that can be employed. Unfortunately, it is presently impossible to preserve the fertility potential of pre-pubertal patients. Due to the increasing numbers of adolescent cancer patients surviving treatment, extensive research is being conducted into several possible methods such as testicular tissue cryopreservation, xenografting, in vitro gamete maturation and even the creation of artificial gametes. However, in spite of its ease, safety, convenience and many accompanying benefits, sperm banking remains underutilized in cancer patients. There are several barriers involved such as the lack of information and the urgency to begin treatment, but various measures can be put in place to overcome these barriers so that sperm banking can be more widely utilized.
Testicular cancer and fertility
International Journal of Andrology, 1987
Before treatment, a little over one-half of patients with testicular cancer have fathered children, while one-fifth have a history of sterility. Radiotherapy with a gonadal dose of less than 1.5 Gy seems to do little permanent damage to fertility. Following cisplatin-based combination chemotherapy, a number of conceptions have been reported. The newer regimens affect spermatogenesis less than earlier ones due to a lower toxicity of the drugs and shorter duration of the treatment. New modifications of retroperitoneal lymphadenectomy may save ejaculatory ability in over one-half of the patients. It is uncertain whether this procedure is less detrimental to fertility than the cisplatin-based combination chemotherapy. Even though semen quality is often poor before treatment, cryopreservation of semen should be considered since in vitro fertilization may be successful even with very poor semen quality. There are no indications in the literature of permanent adverse genetic effects of the treatment.