The number of cancer survivors has grown over the past several decades as a result of advances in diagnosis and treatment. Cure and survival remain each patient’s top priority, but improved survival has spurred greater interest in quality of life after treatment. Comprehensive cancer care for male patients should aim at “minimizing the cost of cure” and maintaining their overall well-being, including their ability to father children. Unfortunately, many may not be able to have children due to the effects of cancer and its treatment.
In this article, we examine the effect of malignancy and anti-cancer treatment on fertility, review current fertility preservation methods, and offer a preview of fertility preservation techniques that hold future promise.
How can cancer affect fertility?
Many types of cancer are associated with impaired semen parameters and infertility. Pain and constitutional manifestations (eg, fever and anorexia) have been associated with impaired semen parameters. Prior to initiation of any treatment, patients with Hodgkin’s disease, testicular cancer, and extragonadal germ cell tumors have impaired semen quality (Ann Oncol 2001; 12:1307-11).
Anticancer treatment can cause persistent or long-lasting damage to the testis. The extent of damage varies with the cancer type, patient age, and type and dosage of the treatment modality (table 1). Typical cytotoxic therapy disrupts spermatogenesis by targeting rapidly dividing spermatogonial stem cells.
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