Fertility and sexual dysfunction in young male cancer survivors

Abstract

Background Newly emerging serious post‐treatment complications among young male cancer survivors involve fertility and sexual function, preventing them from pursuing a normal family life. Methods We studied and summarized published studies that assess the relationship between cancer treatments and reduced spermatogenesis or sexual dysfunction. Main findings Infertility often occurs because of anticancer therapies that impair spermatogenesis. While some patients postremission functionally recover fertility, others experience a decreased sperm count and azoospermia. Fertility‐preserving modalities are currently being promoted worldwide to preserve spermatogenesis following cancer therapy. Patients who can ejaculate and have sperm in their semen should cryopreserve semen. However, for patients who have never ejaculated before puberty or in whom spermatogenesis has not been established, testis biopsy is performed to collect and preserve sperm or germ cells. Fertility preservation is gaining popularity and requires continuous information dissemination to oncologists and cancer treatment professionals. Furthermore, male sexual dysfunction predominantly involves erectile dysfunction and ejaculation disorder. Conclusion Although preventive and therapeutic methods for these disorders have been established within urology, patients and medical professionals in other fields remain uninformed of these advances. Therefore, dissemination of information regarding fertility preservation techniques should be accelerated.

The Incidence and 5-years Relative Survival Rate of Cancer among People Younger than 25 Years in the US, 2000 to 2020: a SEER-retrospective study

“…Common cancer treatments such as radiotherapy and chemotherapy can impair reproductive health and fertility [35][36][37][38][39][40].…”

“…Similarly, some male cancer survivors experience reduced sperm count and azoospermia due to treatments such as high cumulative radiation [37,47]. For instance, when the mean testicular dose exceeds 1 Gy, the rate of oligospermia increases to over 90% at 12 months[48].…”

Analysis of sperm separation protocols for isolating cryopreserved human spermatozoa

“…One area of ART where oxidative stress is known to have a major influence is in sperm cryopreservation (Royere et al, 1996). This technology is being increasingly used as a tool to preserve male fertility, particularly in cancer patients where the deployment of powerful chemotherapeutic agents can have a devastating impact on fertility (Vutyavanich et al 2010;Yumura et al 2022). However, unfortunately, spermatozoa that have been through this process are extremely fragile, exhibiting low levels of motility and high levels of DNA damage in association with all the hallmarks of oxidative stress (Thomson et al 2009;Raad et al 2018;Ghantabpour et al 2022).…”

Preservation of Fertility in Cancer Patients: A Narrative Review

“…However, later-stage germ cells are more resilient to cell-killing impacts. Thus, the production of sperms from later-stage germ cells continues even though spermatogonia declines immediately following cancer therapy [ 15 ]. In prepubescent male patients, prolonged azoospermia can result from a dosage of 6 Gy to the testicles; however, in mature males, the limit is dropped to 2.5 Gy [ 16 ].…”

“…Furthermore, dose fractionation appeared to impair sperm production rather than improve testicular function [ 15 ]. Leydig cells of the testis appear to be much more radiation resistant, as opposed to how it affects the generation of spermatozoa.…”