Skip to main content
SpringerLink
Log in

The Effect of Cancer Therapies on Sperm: Current Guidelines

  • Chapter
  • First Online:
Book cover Biennial Review of Infertility

Abstract

Advances in treatments and improved survival for young men with cancer have led to attempts to preserve or restore fertility in these patients. Baseline fertility is often impaired at the time of cancer diagnosis and is often worsened by subsequent cancer therapies. Fertility is most commonly impaired in testicular cancer followed by Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, and leukemia, and even in those with other solid tumors. Sperm banking prior to therapy remains the most important tool for fertility preservation. Recovery of spermatogenesis may take months to years following chemotherapy or radiation therapy. Attempts to protect spermatogenesis from the effects of these therapies remain experimental and largely unsuccessful. Both chemotherapy and radiation therapy cause damage to sperm DNA with temporary increased rates of aneuploidy. Despite this, most studies show no increase in the rates of congenital anomalies in children born to men following cancer therapies. Future efforts are being directed at protection of spermatogenic cells from damage and germ cell transplantation and in vitro maturation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. De Rooij DG, Russell LD. Everything you wanted to know about spermatogonia but were afraid to ask. J Androl. 2000;21:776–98.

    PubMed  Google Scholar 

  2. Bordallo MA, Guimaraes MM, et al. Decreased serum inhibin B/FSH ratio as a marker of Sertoli cell function in male survivors after chemotherapy in childhood and adolescence. J Pediatr Endocrinol Metab. 2004;17(6):879–87.

    Article  PubMed  CAS  Google Scholar 

  3. Crofton PM, Thomson AB, et al. Is inhibin B a potential marker of gonadotoxicity in prepuberal children treated for cancer? Clin Endocrinol. 2003;58(3):296–301.

    Article  CAS  Google Scholar 

  4. Schlatt S, Arslan M, et al. Endocrine control of testicular somatic and premeiotic germ cell development in the immature testis of the primate Macaca mulatta. Eur J Endocrinol. 1995;113:235–47.

    Article  Google Scholar 

  5. Schlatt S, Weinbauer GF. Immunohistochemical localization of proliferating cell nuclear antigen as a tool to study cell proliferation in rodent and primate testes. Int J Androl. 1994;17:214–22.

    Article  PubMed  CAS  Google Scholar 

  6. Matsumiya K, Meistrich ML, et al. Stimulation of spermatogonial differentiation in juvenile spermatogonial depletion (jsd) mutant mice by gonadotropin releasing hormone antagonist. Endocrinology. 1999;140:4912–5.

    Article  PubMed  CAS  Google Scholar 

  7. Bahadur G, Ling KL, et al. Semen quality and cryopreservation in adolescent cancer patients. Hum Reprod. 2002;17:3157–61.

    Article  PubMed  CAS  Google Scholar 

  8. Dohle GR. Male infertility in cancer patients: review of the literature. Int J Urol. 2010;17:327–31.

    Article  PubMed  Google Scholar 

  9. Foster RS, Rubin LR, et al. Detection of anti-sperm antibodies in patients with primary testicular cancer. Int J Androl. 1991;14:179–85.

    Article  PubMed  CAS  Google Scholar 

  10. Ho GT, Gardner H, et al. The effect of testicular non-germ cell tumors on local spermatogenesis. Fertil Steril. 1994;62:162–6.

    PubMed  CAS  Google Scholar 

  11. Ho GT, Gardner H, et al. Influence of testicular carcinoma on ipsilateral spermatogenesis. J Urol. 1992;148:821–5.

    PubMed  CAS  Google Scholar 

  12. Petersen PM, Skakkebaek NE, Giwercman A. Gonadal function in men with testicular cancer: biological and clinical aspects. APMIS. 1998;106:24–36.

    Article  PubMed  CAS  Google Scholar 

  13. Berthelsen JG, Skakkebaek NE. Gonadal function in men with testicular cancer. Fertil Steril. 1983;39:68–75.

    PubMed  CAS  Google Scholar 

  14. Willemse PHB, Sleiffer DT, et al. Altered Leydif cell function in patients with testicular cancer: evidence for a bilateral testicular defect. Acta Endocrinol. 1983;102:616–24.

    PubMed  CAS  Google Scholar 

  15. Petersen PM, Giwercman A, et al. Impaired testicular function in patients with carcinoma in situ of the ­testis. J Clin Oncol. 1999;17(1):173–9.

    PubMed  CAS  Google Scholar 

  16. Jacobsen KD, Fossa SD, et al. Gonadal function and fertility in patients with bilateral testicular germ cell malignancy. Eur Urol. 2002;42:229–38.

    Article  PubMed  Google Scholar 

  17. Che M, Tamboli P, et al. Bilateral testicular germ cell tumors: twenty-year experience at M.D. Andersen Cancer Center. Cancer. 2002;95:1228–33.

    Article  PubMed  Google Scholar 

  18. Heidenreich A, Weissbach L, et al. Organ sparing-surgery for malignant germ cell tumor of the testis. J Urol. 2001;166:2161–5.

    Article  PubMed  CAS  Google Scholar 

  19. Dieckmann KP, Loy V. Prevalence of contralateral testicular intraepithelial neoplasia in patients with ­testicular germ cell neoplasms. J Clin Oncol. 1996;14:3121–5.

    Google Scholar 

  20. Lass A, Akagbosu F, et al. A programme of semen cryopreservation for patients with malignant disease in a tertiary infertility center: lessons from 8 years’ experience. Hum Reprod. 1998;13(11):3256–61.

    Article  PubMed  CAS  Google Scholar 

  21. Rueffer U, Breuer K, et al. Male gonadal dysfunction in patient’s with Hodgkin’s disease prior to treatment. Ann Oncol. 2001;12:1307–11.

    Article  PubMed  CAS  Google Scholar 

  22. Sieniawski M, Reineke T, et al. Assessment of male fertility in patient’s with Hodgkin’s lymphoma treated in the German Hodgkin Study Group (GHSG) clinical trials. Ann Oncol. 2008;19:1795–801.

    Article  PubMed  CAS  Google Scholar 

  23. Van Beek RD, Smit M, et al. Inhibin B is superior to FSH as a serum marker for spermatogenesis in men treated for Hodgkin’s lymphoma with chemotherapy during childhood. Hum Reprod. 2007;22(12):3215–22.

    Article  PubMed  Google Scholar 

  24. Kulkarni SS, Sastry PS, et al. Gonadal function following ABVD therapy for Hodgkin’s disease. Am J Clin Oncol. 1997;20:354–7.

    Article  PubMed  CAS  Google Scholar 

  25. Hallak J, Kolletis PN, et al. Cryopreservation of sperm from patients with leukemia: is it worth the effort? Cancer. 1999;85(9):1973–8.

    PubMed  CAS  Google Scholar 

  26. Van der Kaaij MAE, Heutte N, et al. Sperm quality before treatment in patients with early stage Hodgkin lymphoma enrolled in EORTC-GELA lymphoma group trials. Haematologica. 2009;94:1691–7.

    Article  PubMed  Google Scholar 

  27. Puscheck E, Philip PA, Jeyendran RS. Male fertility preservation and cancer treatment. Cancer Treat Rev. 2004;30:173–80.

    Article  PubMed  Google Scholar 

  28. Maymon BB, Yogev L, et al. Sertoli cell inactivation by cytotoxic damage to the human testis after cancer chemotherapy. Fertil Steril. 2004;81(5):1391–4.

    Article  Google Scholar 

  29. Lampe H, Horwich A, et al. Fertility after chemotherapy for testicular germ cell cancer. J Clin Oncol. 1997;15:239–45.

    PubMed  CAS  Google Scholar 

  30. Howell SJ, Shalat SM. Testicular function following chemotherapy. Hum Reprod Update. 2002;7:363–9.

    Article  Google Scholar 

  31. Delbes G, Hales BF, Robaire B. Effects of chemotherapy cocktail used to treat testicular cancer on sperm chromatin integrity. J Androl. 2007;28(2):241–9.

    Article  PubMed  CAS  Google Scholar 

  32. Schmidt KLT, Carlsen E, Andersen AN. Fertility treatment in male cancer survivors. Int J Androl. 2007;30:413–9.

    Article  PubMed  Google Scholar 

  33. Peterson PM, Giwercman A, et al. Effect of graded testicular doses of radiotherapy in patients treated for carcinoma in situ of the testis. J Clin Oncol. 2002;20:1537–43.

    Article  Google Scholar 

  34. Giwercman A, von der Maase H, et al. Localised irradiation of testis with carcinoma in situ: effects on Leydig cell function and eradication of malignant germ cells in 20 patients. J Clin Endocrinol Metab. 1991;73:596–603.

    Article  PubMed  CAS  Google Scholar 

  35. Bieri S, Rouzaud M, Miralbell R. Seminoma of the testis: is scrotal shielding necessary when radiotherapy is limited to the para-aortic nodes? Radiother Oncol. 1999;50(3):349–53.

    Article  PubMed  CAS  Google Scholar 

  36. Hansen PV, Trykker H, et al. Long-term recovery of spermatogenesis after radiotherapy in patients with testicular cancer. Radiother Oncol. 1990;18:117–25.

    Article  PubMed  CAS  Google Scholar 

  37. Huyghe E, Matsuda T, et al. Fertility after testicular cancer treatments: results of a large multicenter study. Cancer. 2004;100:732–7.

    Article  PubMed  Google Scholar 

  38. Hahn EW, Feingold SM, et al. Recovery from aspermia induced by low-dose radiation in seminoma patients. Cancer. 1982;50:337–40.

    Article  PubMed  CAS  Google Scholar 

  39. Fossa SD, Kravdal O. Fertility in Norwegian testicular cancer patients. Br J Cancer. 2000;82:737–41.

    Article  PubMed  CAS  Google Scholar 

  40. Bakker B, Massa GG, et al. Pubertal development and growth after total-body irradiation and bone marrow transplantation. Eur J Pediatr. 2000;159:31–7.

    Article  PubMed  CAS  Google Scholar 

  41. Anserini P, Chiodi S, et al. Semen analysis following allogeneic bone marrow transplantation. Bone Marrow Transplant. 2002;30:447–51.

    Article  PubMed  CAS  Google Scholar 

  42. Kyriacou C, Kottardis PD, et al. Germ cell damage and Leydig cell insufficiency in recipients of nonmyeloablative transplantation for hematological malignancies. Bone Marrow Transplant. 2003;31:45–50.

    Article  PubMed  CAS  Google Scholar 

  43. Bahadur G, Ozturk O, et al. Semen quality before and after gonadotoxic treatment. Hum Reprod. 2005;20:774–81.

    Article  PubMed  CAS  Google Scholar 

  44. Brydoy M, Fossa SD, et al. Paternity following treatment for testicular cancer. J Natl Cancer Inst. 2005;97:1580–8.

    Article  PubMed  Google Scholar 

  45. Tempest HG, Ko E, et al. Sperm aneuplody frequencies before and after chemotherapy in testicular ­cancer and Hodgkin’s lymphoma patients. Hum Reprod. 2008;23(2):251–8.

    Article  PubMed  CAS  Google Scholar 

  46. Schover LR, Brey K, et al. Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. J Clin Oncol. 2002;20:1880–9.

    Article  PubMed  Google Scholar 

  47. Bahadur G, Ling KLE, et al. Semen production in adolescent cancer patients. Hum Reprod. 2002;17(10):2654–6.

    Article  PubMed  CAS  Google Scholar 

  48. Schrader M, Muller M, et al. “Onco-TESE”: testicular sperm extraction in azoospermic cancer patients before chemotherapy – new guidelines? Urology. 2003;61:421–5.

    Article  PubMed  CAS  Google Scholar 

  49. Meacham RB. Testicular sperm retrieval in the management of chemotherapy-induced azoospermia. J Androl. 2003;24(6):807.

    PubMed  Google Scholar 

  50. Chan PTK, Palermo GD, et al. Testicular sperm extraction combined with intracytoplasmic sperm injection in the treatment of men with persistent azoospermia postchemotherapy. Cancer. 2001;92:1632–7.

    Article  PubMed  CAS  Google Scholar 

  51. Meseguer M, Garrido N, et al. Testicular sperm extraction (TESE) and ICSI in patients with ­permanent azoospermia after chemotherapy. Hum Reprod. 2003;18(6):1281–5.

    Article  PubMed  CAS  Google Scholar 

  52. Damani MN, Master V, et al. Post-chemotherapy ejaculatory azoospermia: fatherhood with sperm from testis tissue with intracytoplasmic sperm injection. J Clin Oncol. 2002;20:888–90.

    Article  Google Scholar 

  53. Meistrich ML. Restoration of spermatogenesis by hormone treatment after cytotoxic therapy. Acta Paediatr Suppl. 1999;88(433):19–22.

    Article  PubMed  CAS  Google Scholar 

  54. Meacham S, von Schonfeld V, et al. Spermatogonia: stem cells with a great perspective. Hum Reprod. 2001;12:825–34.

    Google Scholar 

  55. Schlatt S, Foppiani L, et al. Germ cell transplantation into X-irradiated monkey testes. Hum Reprod. 2002;17(1):55–62.

    Article  PubMed  CAS  Google Scholar 

  56. Tesarik J, Bagceci M, et al. Restoration of fertility by in-vitro spermatogenesis. Lancet. 1999;353:555–6.

    Article  PubMed  CAS  Google Scholar 

  57. Spermon JR, Ramos L, et al. Sperm integrity pre and post chemotherapy in med with testicular cancer. Hum Reprod. 2006;21(7):1781–6.

    Article  PubMed  CAS  Google Scholar 

  58. Tempest HGT, Ko E, Chan P, Robaire B, Rademaker A, Martin RH. Sperm aneuploidy frequencies analysed before and after chemotherapy in testicular cancer and Hodgkin’s lymphoma patients. Hum Reprod. 2008;23:251–8.

    Article  PubMed  CAS  Google Scholar 

  59. Thomson AB, Campbell AJ, et al. Semen quality and spermatozoal DNA integrity in survivors of childhood cancer: a case-control study. Lancet. 2002;360(9330):361–7.

    Article  PubMed  CAS  Google Scholar 

  60. Robbins WA, Meistrich ML, et al. Chemotherapy induces transient sex chromosomal and autosomal aneuploidy in human sperm. Nat Genet. 1997;16(1):74–8.

    Article  PubMed  CAS  Google Scholar 

  61. Thomas C, Cans C, et al. No long-term increase in sperm aneuploidy rates after anticancer therapy: sperm fluorescence in situ hybridization analysis in 26 patients treated for testicular cancer or lymphoma. Clin Cancer Res. 2004;10:6535–43.

    Article  PubMed  CAS  Google Scholar 

  62. Dodds L, Marrett LD, et al. Case-control study of congenital anomalies in children of cancer patients. Br Med J. 1993;307(6897):164–8.

    Article  CAS  Google Scholar 

  63. Senturia YD, Peckham CS. Children fathered by men treated with chemotherapy for testicular cancer. Eur J Cancer. 1990;26(4):429–32.

    Article  PubMed  CAS  Google Scholar 

  64. Naysmith TE, Blake DA, et al. Do men undergoing sterilizing cancer treatments have a fertile future? Hum Reprod. 1998;13:3250–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urology, Rhode Island Hospital, Warren Alpert Medical School at Brown University, Providence, RI, USA

    Mark Sigman

Authors
  1. Akanksha Mehta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mark Sigman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark Sigman .

Editor information

Editors and Affiliations

  1. Brigham & Women's Hospital, Dept. Obstetrics & Gynecology, Harvard Medical School, Francis St. 75, Boston, 02115, Massachusetts, USA

    Catherine Racowsky

  2. Weill Cornell Medical Center, Dept. Urology, New York Presbyterian Hospital, East 68th St. 525, New York, 10021, New York, USA

    Peter N. Schlegel

  3. , Department of Reproductive Medicine, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, Netherlands

    Bart C. Fauser

  4. Departments of Surgery (Urology), Obstetrics & Gynecology & Physiology, Andrology and IVF Laboratories, Arapeen Dr. 675, Salt Lake City, 84108, Utah, USA

    Douglas T. Carrell

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Mehta, A., Sigman, M. (2011). The Effect of Cancer Therapies on Sperm: Current Guidelines. In: Racowsky, C., Schlegel, P., Fauser, B., Carrell, D. (eds) Biennial Review of Infertility. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-8456-2_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-8456-2_10

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-8455-5

  • Online ISBN: 978-1-4419-8456-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation