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Impact of Radiotherapy and Chemotherapy on the Testis

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Abstract

Nowadays, anticancer treatments involving either chemotherapy or radiotherapy have become increasingly successful and the survival rates have dramatically improved in the last 30 years from less than 20% to nearly 80%. However, according to the doses used and the duration of the treatment, 10–100% of surviving cancer patients will show reduced semen parameters and overall 15–30% will remain sterile on the long term. Interindividual variability exists in the spermatogenetic recovery after any gonadotoxic treatment making any individual fertility prognosis virtually impossible. Furthermore, while the initial treatment is known when starting cancer therapy, eventually the treatment regimen may be changed making any assessment of the risk for sterility even more difficult. Therefore, sperm cryopreservation should be offered routinely to all male patients exposed to gonadotoxic treatments. Age must not be a discriminative parameter since different methods to obtained semen sample are available to obtain sperm from postpubertal patients. When patients have been cured, assisted reproduction, e.g., intracytoplasmic sperm injection can be used to offer patients the best chances to father their genetically own children. In prepubertal boys, testicular stem cell banking may be offered.

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Authors and Affiliations

  1. Centre for Reproductive Medicine, University Hospital, Dutch-speaking Brussels Free University, Brussels, Belgium

    Carolina Ortega MD (Clinical Fellow)

  2. Centre for Reproductive Medicine, University Hospital, Dutch-speaking Brussels Free University, Laarbeeklaan 101, 1090, Brussels, Belgium

    Herman Tournaye MD, PhD (Professor)

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  1. Carolina Ortega MD
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  2. Herman Tournaye MD, PhD
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Editors and Affiliations

  1. School of Medicine, Department of Obstetrics, Gynecology, Yale University, Cedar St. 333, New Haven, 06510, Connecticut, USA

    Emre Seli

  2. , Director, Center for Reproductive, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, 44195, Ohio, USA

    Ashok Agarwal

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Ortega, C., Tournaye, H. (2012). Impact of Radiotherapy and Chemotherapy on the Testis. In: Seli, E., Agarwal, A. (eds) Fertility Preservation. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1783-6_20

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