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The Effect of Cancer and Its Treatment on Natural-Born Offspring

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The Complete Guide to Male Fertility Preservation

Abstract

The literature describing the impact of cancer and its treatment on spermatogenesis, likelihood of natural conception, and discussion of potential congenital abnormalities as a result of DNA damage in sperm is discussed in this chapter.

Many patients diagnosed with cancer are of reproductive age. As advancements in medicine lead to improvements in cancer diagnosis and treatment, more of these younger patients survive. Given increasing 5-year survival rates, it is becoming increasingly important to consider future fertility in patients undergoing cancer treatment. Therefore all males of pubertal age and older should have a discussion with their physician regarding fertility preservation prior to receiving treatment for cancer.

Men with cancer before receiving treatment are more frequently observed to have abnormal semen parameters due to anatomic and physiologic disruptions. This has been observed for many different types of malignancies, but it is magnified in the testicular cancer population.

Among the different modalities for cancer treatment, chemotherapy and radiation have been shown to cause direct damage to spermatogonia and therefore affect spermatogenesis. Surgery affects fertility by alterations in anatomy. After treatment with chemotherapy, abnormal sperm DNA fragmentation and aneuploidy rates have been observed.

With regard to congenital abnormalities of offspring as a result of cancer treatment, data suggest that children born to fathers within the first 2 years of cancer diagnosis and those men diagnosed with cancer in childhood have a statistically significant, but likely clinically insignificant, increase in congenital abnormalities. When compared with natural conception, assisted reproductive technology was associated with increased risk for low birth weight and preterm delivery, and a 20% increased risk of major congenital abnormality regardless of paternal cancer history.

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Author information

Authors and Affiliations

  1. Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA

    Zachary J. McDowell MD & Mark S. Hockenberry MD

  2. Scott Department of Urology, Baylor College of Medicine, 6624 Fannin Street, Suite 1700, Houston, TX, 77030, USA

    Larry I. Lipshultz MD

Authors
  1. Zachary J. McDowell MD
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  2. Mark S. Hockenberry MD
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  3. Larry I. Lipshultz MD
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Corresponding author

Correspondence to Larry I. Lipshultz MD .

Editor information

Editors and Affiliations

  1. Department of Urology, Hamad Medical Corporation, Doha, Qatar

    Ahmad Majzoub

  2. Department of Urology, Andrology Center, Cleveland Clinic, Cleveland, Ohio, USA

    Ashok Agarwal

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McDowell, Z.J., Hockenberry, M.S., Lipshultz, L.I. (2018). The Effect of Cancer and Its Treatment on Natural-Born Offspring. In: Majzoub, A., Agarwal, A. (eds) The Complete Guide to Male Fertility Preservation. Springer, Cham. https://doi.org/10.1007/978-3-319-42396-8_5

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  • DOI: https://doi.org/10.1007/978-3-319-42396-8_5

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-42396-8

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