Current Treatment Options in Oncology

, Volume 13, Issue 2, pp 146–160 | Cite as

Oncofertility and the Male Cancer Patient

Oncofertility (JS Jeruss, Section Editor)

Opinion statement

Oncofertility as a discipline plays an important, adjunctive role in the treatment of male patients with cancer. Despite recommendations by the American Society of Clinical Oncology, many clinicians managing malignancies in males fail to consistently incorporate fertility preservation as a routine aspect of health care. Providers involved in the treatment of oncologic patients should have an awareness of the impact of their prescribed treatments on reproductive potential, just as they would be knowledgeable of the potential deleterious effects of cancer therapies on vital organs such as the kidneys, lungs, and liver. Providers should then have a discussion with their patients regarding these potential adverse therapeutic effects or consult a fertility preservation specialist to discuss these matters and fertility preservation options with the patient. Cryopreservation of sperm remains an excellent option for male fertility preservation as it is readily available and results in storage of viable gametes for future use in the event of post treatment infertility. With the use of assisted reproductive techniques (ART), cryopreserved sperm may ultimately result in successful paternity, even in the setting of very low numbers of stored sperm. While sperm cryopreservation is usually an option for adolescent and adult males, fertility preservation in pre-pubertal males presents a more challenging problem. To date, no clinically proven methods are available to preserve fertility in these males. However, some centers do offer experimental protocols under the oversight of an IRB, such as testicular tissue cryopreservation in these males. The hope is that one day science will provide a mechanism for immature germ cells from the testicular tissue of these patients to be used in vivo or in vitro to facilitate reproduction. In closing, studies have shown that the patient’s regard for his provider is enhanced when the issue fertility preservation is raised. While oncologic care is often fraught with time constraints and acute medical concerns, fertility preservation care in the male can typically be administered quickly and without disruption of the overall plan of care.

Keywords

Oncofertility Male patients Cancer Assisted reproductive techniques Cryopreservation 

Abbreviations

ART

Assisted reproductive techniques

ASCO

American Society of Clinical Oncology

ASRM

American Society for Reproductive Medicine

FSH

Follicle stimulating hormone

GnRH

Gonadotropic releasing hormone

Gy

Gray

HCG

Human chorionic gonadotropin

IVF

In-vitro fertilization

ICSI

Intracytoplasmic sperm injection

LH

Luteinizing hormone

RPLND

Retroperitoneal lymph node dissection

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of UrologyMayo ClinicRochesterUSA
  2. 2.Department of UrologyNorthwestern University, Feinberg School of MedicineChicagoUSA

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