Skip to main content
SpringerLink
Log in

Fertility Preservation Strategies in the Male Cancer Patient

  • Chapter
  • First Online:
Cancer and Fertility

Part of the book series: Current Clinical Urology ((CCU))

  • 691 Accesses

Abstract

Advances in oncology have improved cancer survivor rates to record numbers. The conversation with patients who are newly diagnosed with cancer must include fertility preservation strategies given the possibility of infertility, which they will face as a cancer survivor. In this chapter, barriers to fertility preservation in males considering gonadotoxic therapy, including obstacles unique to the newly diagnosed cancer patient, will be discussed. In addition, we will focus on fertility preservation strategies available prior to chemotherapy or radiation, as well as present options available to the posttreatment cancer survivor. Sperm cryopreservation utilizing ejaculated specimens, penile vibratory stimulation, electroejaculation, microscope assisted surgical sperm retrieval from the epididymis (MESA) and testis (microTESE), and ex vivo sperm retrieval are all viable options for fertility preservation, which will be discussed at length. Finally, special considerations for the pediatric cancer patient and future considerations for the male cancer patient who cryopreserved sperm will be presented.

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 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
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. Loren AW, Mangu PB, Beck LN, et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:2500–10.

    Article  PubMed  Google Scholar 

  2. Ethics Committee of American Society for Reproductive M. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. Fertil Steril. 2013;100:1224–31.

    Article  Google Scholar 

  3. Quinn GP, Vadaparampil ST, Lee JH, et al. Physician referral for fertility preservation in oncology patients: a national study of practice behaviors. J Clin Oncol. 2009;27:5952–7.

    Article  PubMed  Google Scholar 

  4. Adams E, Hill E, Watson E. Fertility preservation in cancer survivors: a national survey of oncologists’ current knowledge, practice and attitudes. Br J Cancer. 2013;108:1602–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Loren AW, Brazauskas R, Chow EJ, et al. Physician perceptions and practice patterns regarding fertility preservation in hematopoietic cell transplant recipients. Bone Marrow Transplant. 2013;48:1091–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Wasilewski-Masker K, Seidel KD, Leisenring W, et al. Male infertility in long-term survivors of pediatric cancer: a report from the childhood cancer survivor study. J Cancer Surviv. 2014;8:437–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Green DM, Liu W, Kutteh WH, et al. Cumulative alkylating agent exposure and semen parameters in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort Study. Lancet Oncol. 2014;15:1215–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Trost LW, Brannigan RE. Oncofertility and the male cancer patient. Curr Treat Options Oncol. 2012;13:146–60.

    Article  PubMed  Google Scholar 

  9. Joshi S, Savani BN, Chow EJ, et al. Clinical guide to fertility preservation in hematopoietic cell transplant recipients. Bone Marrow Transplant. 2014;49:477–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Schover LR, Brey K, Lichtin A, Lipshultz LI, Jeha S. Oncologists’ attitudes and practices regarding banking sperm before cancer treatment. J Clin Oncol. 2002;20:1890–7.

    Article  PubMed  Google Scholar 

  11. Quinn GP, Vadaparampil ST, Gwede CK, et al. Discussion of fertility preservation with newly diagnosed patients: oncologists’ views. J Cancer Surviv. 2007;1:146–55.

    Article  PubMed  Google Scholar 

  12. Quinn GP, Murphy D, Knapp C, et al. Who decides? Decision making and fertility preservation in teens with cancer: a review of the literature. J Adolesc Health. 2011;49:337–46.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Sadri-Ardekani H, Akhondi MM, Vossough P, et al. Parental attitudes toward fertility preservation in boys with cancer: context of different risk levels of infertility and success rates of fertility restoration. Fertil Steril. 2013;99:796–802.

    Article  PubMed  Google Scholar 

  14. Ayensu-Coker L, Essig E, Breech LL, Lindheim S. Ethical quandaries in gamete-embryo cryopreservation related to oncofertility. J Law Med Ethics. 2013;41:711–9.

    Article  PubMed  Google Scholar 

  15. Quinn GP, Vadaparampil ST, King L, et al. Impact of physicians’ personal discomfort and patient prognosis on discussion of fertility preservation with young cancer patients. Patient Educ Couns. 2009;77:338–43.

    Article  PubMed  Google Scholar 

  16. Pacey AA, Eiser C. Banking sperm is only the first of many decisions for men: what healthcare professionals and men need to know. Hum Fertil. 2011;14:208–17.

    Article  Google Scholar 

  17. Ku JY, Park NC, Jeon TG, Park HJ. Semen analysis in cancer patients referred for sperm cryopreservation before chemotherapy over a 15-year period in Korea. World J Mens Health. 2015;33:8–13.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Williams DH, Karpman E, Sander JC, Spiess PE, Pisters LL, Lipshultz LI. Pretreatment semen parameters in men with cancer. J Urol. 2009;181:736–40.

    Article  PubMed  Google Scholar 

  19. Muller J, Sonksen J, Sommer P, et al. Cryopreservation of semen from pubertal boys with cancer. Med Pediatr Oncol. 2000;34:191–4.

    Article  CAS  PubMed  Google Scholar 

  20. Qiu Y, Wang LG, Zhang LH, Zhang AD, Wang ZY. Quality of sperm obtained by penile vibratory stimulation and percutaneous vasal sperm aspiration in men with spinal cord injury. J Androl. 2012;33:1036–46.

    Article  CAS  PubMed  Google Scholar 

  21. Sonksen J, Biering-Sorensen F, Kristensen JK. Ejaculation induced by penile vibratory stimulation in men with spinal cord injuries. The importance of the vibratory amplitude. Paraplegia. 1994;32:651–60.

    Article  CAS  PubMed  Google Scholar 

  22. Brackett NL, Ferrell SM, Aballa TC, et al. An analysis of 653 trials of penile vibratory stimulation in men with spinal cord injury. J Urol. 1998;159:1931–4.

    Article  CAS  PubMed  Google Scholar 

  23. Iremashvili V, Brackett NL, Ibrahim E, Aballa TC, Lynne CM. The choice of assisted ejaculation method is relevant for the diagnosis of azoospermia in men with spinal cord injuries. Spinal Cord. 2011;49:55–9.

    Article  CAS  PubMed  Google Scholar 

  24. Adank MC, van Dorp W, Smit M, et al. Electroejaculation as a method of fertility preservation in boys diagnosed with cancer: a single-center experience and review of the literature. Fertil Steril. 2014;102:199–205. e1.

    Article  PubMed  Google Scholar 

  25. Gat I, Toren A, Hourvitz A, et al. Sperm preservation by electroejaculation in adolescent cancer patients. Pediatr Blood Cancer. 2014;61:286–90.

    Article  PubMed  Google Scholar 

  26. Berookhim BM, Mulhall JP. Outcomes of operative sperm retrieval strategies for fertility preservation among males scheduled to undergo cancer treatment. Fertil Steril. 2014;101:805–11.

    Article  PubMed  Google Scholar 

  27. Haddad N, Al-Rabeeah K, Onerheim R, Zini A. Is ex vivo microdissection testicular sperm extraction indicated for infertile men undergoing radical orchiectomy for testicular cancer? Case report and literature review. Fertil Steril. 2014;101:956–9.

    Article  PubMed  Google Scholar 

  28. Tournaye H, Goossens E, Verheyen G, et al. Preserving the reproductive potential of men and boys with cancer: current concepts and future prospects. Hum Reprod Update. 2004;10:525–32.

    Article  PubMed  Google Scholar 

  29. Aponte PM. Spermatogonial stem cells: current biotechnological advances in reproduction and regenerative medicine. World J Stem Cells. 2015;7:669–80.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Tournaye H, Dohle GR, Barratt CL. Fertility preservation in men with cancer. Lancet. 2014;384:1295–301.

    Article  PubMed  Google Scholar 

  31. Ginsberg JP, Carlson CA, Lin K, et al. An experimental protocol for fertility preservation in prepubertal boys recently diagnosed with cancer: a report of acceptability and safety. Hum Reprod. 2010;25:37–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Meistrich ML, Shetty G. Hormonal suppression for fertility preservation in males and females. Reproduction. 2008;136:691–701.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Blumenfeld Z. Gender difference: fertility preservation in young women but not in men exposed to gonadotoxic chemotherapy. Minerva Endocrinol. 2007;32:23–34.

    CAS  PubMed  Google Scholar 

  34. Quinn GP, Vadaparampil ST. More research, more responsibility: the expansion of duty to warn in cancer patients considering fertility preservation. Am J Obstet Gynecol. 2013;209:98–102.

    Article  PubMed  Google Scholar 

  35. Morris ID. Sperm DNA, damage and cancer treatment. Int J Androl. 2002;25:255–61.

    Article  CAS  PubMed  Google Scholar 

  36. Nangia AK, Krieg SA, Kim SS. Clinical guidelines for sperm cryopreservation in cancer patients. Fertil Steril. 2013;100:1203–9.

    Article  PubMed  Google Scholar 

  37. Di Santo M, Tarozzi N, Nadalini M, Borini A. Human sperm cryopreservation: update on techniques, effect on DNA integrity, and implications for ART. Adv Urol. 2012;2012:854837.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ping P, Gu BH, Li P, Huang YR, Li Z. Fertility outcome of patients with testicular tumor: before and after treatment. Asian J Androl. 2014;16:107–11.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Djaladat H, Burner E, Parikh PM, Beroukhim Kay D, Hays K. The association between testis cancer and semen abnormalities before orchiectomy: a systematic review. J Adolesc Young Adult Oncol. 2014;3:153–9.

    Article  PubMed  PubMed Central  Google Scholar 

  40. van Casteren NJ, Boellaard WP, Romijn JC, Dohle GR. Gonadal dysfunction in male cancer patients before cytotoxic treatment. Int J Androl. 2010;33:73–9.

    Article  PubMed  Google Scholar 

  41. Paoli D, Gallo M, Rizzo F, et al. Testicular cancer and sperm DNA damage: short- and long-term effects of antineoplastic treatment. Andrology. 2015;3:122–8.

    Article  CAS  PubMed  Google Scholar 

  42. Collins JA, Barnhart KT, Schlegel PN. Do sperm DNA integrity tests predict pregnancy with in vitro fertilization? Fertil Steril. 2008;89:823–31.

    Article  PubMed  Google Scholar 

  43. Zini A, Boman JM, Belzile E, Ciampi A. Sperm DNA damage is associated with an increased risk of pregnancy loss after IVF and ICSI: systematic review and meta-analysis. Hum Reprod. 2008;23:2663–8.

    Article  CAS  PubMed  Google Scholar 

  44. Chow EJ, Kamineni A, Daling JR, et al. Reproductive outcomes in male childhood cancer survivors: a linked cancer-birth registry analysis. Arch Pediatr Adolesc Med. 2009;163:887–94.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Fossa SD, Magelssen H, Melve K, Jacobsen AB, Langmark F, Skjaerven R. Parenthood in survivors after adulthood cancer and perinatal health in their offspring: a preliminary report. J Natl Cancer Inst Monogr. 2005;34:77–82.

    Article  PubMed  Google Scholar 

  46. Madanat-Harjuoja LM, Malila N, Lahteenmaki P, et al. Risk of cancer among children of cancer patients—a nationwide study in Finland. Int J Cancer. 2010;126:1196–205.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Botchan A, Karpol S, Lehavi O, et al. Preservation of sperm of cancer patients: extent of use and pregnancy outcome in a tertiary infertility center. Asian J Androl. 2013;15:382–6.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Olatunbosun OA, Zhu L. The role of sperm banking in fertility preservation. Clin Exp Obstet Gynecol. 2012;39:283–7.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, George Washington University, 2150 Pennsylvania Ave, NW Suite 3-417, Washington, DC, 20037, USA

    Kelly A. Chiles M.D., M.Sc.

  2. Department of Urology, New York Presbyterian/Weill Cornell Medical Center, Starr 900, 525 E 68th Street, New York, NY, 10065, USA

    Kelly A. Chiles M.D., M.Sc. & Peter N. Schlegel M.D.

Authors
  1. Kelly A. Chiles M.D., M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter N. Schlegel M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter N. Schlegel M.D. .

Editor information

Editors and Affiliations

  1. Lerner College of Medi, Cleveland Clinic, Department of Urology, Cleveland, Ohio, USA

    Edmund S. Sabanegh, Jr.

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Chiles, K.A., Schlegel, P.N. (2016). Fertility Preservation Strategies in the Male Cancer Patient. In: Sabanegh, Jr., E. (eds) Cancer and Fertility. Current Clinical Urology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-27711-0_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27711-0_10

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-27709-7

  • Online ISBN: 978-3-319-27711-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation