Options for Fertility Preservation in Men and Boys with Cancer

Preservation of fertility in teenagers and young adults treated for haematological malignancies

“…In most post-pubertal males, the process of providing sperm for cryopreservation is effective, inexpensive, and non-invasive. b) Electro-ejaculation Electro-ejaculation under general anesthesia (Stahl et al 2012 56 ) is an alternative technique that can be used to obtain mature sperm in pubertal boys who are unable to produce a semen sample through masturbation prior to commencement of chemotherapy. This technique should not be used in patients with hematological malignancy who are pancytopenic as it may lead to a significant risk of sepsis from bacteria in the gut.…”

Evaluation and preservation of fertility in adolescent and young adult patients with testicular cancer

“…In the largest published case Options for fertility preservation in men and boys with cancer. 53 series, Schrader et al reported successful retrieval of sperm in six of 14 azoospermic men with testicular cancer. 40…”

Current practices in fertility preservation in male cancer patients

“…Such an operation may cause an ejaculation or retrograde ejaculation due to disruption of the lumbar sympathetic plexus and hypogastic plexus. [32] To best prevent these consequences, modified nerve-sparing procedures are performed with a reported ejaculatory preservation of 50-85% in men. [33]…”

“…This is the preferred method as it provides the best quality sperm at the lowest financial cost. [32] Should no ejaculate be achieved or if the patient has a history of retrograde ejaculation, a post-ejaculate urinalysis should be done to assess for sperm in the urine. If sperm are present in the urine sample, a trial of alpha agonists may be administered to direct ejaculate forwards.…”

“…These include vibratory stimulation and electro-ejaculation in an effort to induce ejaculation. [32] For azoospermic men, more invasive surgical techniques for sperm extraction such as microsurgical testicular sperm extraction (microTESE) or microsurgical epididymal sperm aspiration (MESA) are performed prior to cancer therapy. Prior to chemotherapy, patients may be rendered azoospermic as a result of their testicular tumor burden.…”