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Review
. 2014 Mar;3(1):27-40.
doi: 10.3978/j.issn.2223-4683.2014.02.06.

Contemporary and future insights into fertility preservation in male cancer patients

Affiliations
Review

Contemporary and future insights into fertility preservation in male cancer patients

Ashok Agarwal et al. Transl Androl Urol. 2014 Mar.

Abstract

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.

Keywords: Cancer; fertility preservation; male infertility; sperm banking.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Effects of the three main modalities of cancer treatment on the male reproductive potential.
Figure 2
Figure 2
Algorithm showing the process of sperm banking from initial diagnosis of cancer to possible methods of sperm collection, followed by sperm cryopreservation and thawing, and depending on the sperm parameters obtained, its use in suitable assisted reproduction techniques. EEJ, electro-ejaculation; PVS, penile vibrostimulation; PESA, percutaneous epididymal sperm aspiration; MESA, microsurgical epididymal sperm aspiration; TESA, testicular sperm aspiration; TESE, testicular sperm extraction; IVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection; IUI, intrauterine insemination.

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