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Assessing Testicular Reserve in the Male Oncology Patient

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Abstract

Fertility preservation is of utmost importance to males diagnosed with malignancies, but this care does not only occur in the pretreatment setting. Longitudinal follow-up is needed to determine the duration and extent of spermatogenesis impairment in men. When assessing testicular reserve in a male cancer survivor, clinicians should keep in mind that the minimum initial evaluation of the patient should include a full medical history, physical examination, and measurement of serum testosterone and FSH levels. Additionally, semen analysis is currently the gold standard for assessing fertility status in the male. This test is readily available at most tertiary care centers and can be performed at any age after puberty.

Keeping in mind that these tests are not perfect and do not represent ideal biomarkers, research has shifted to developing more sensitive, specific, low-cost, and attainable tests. Looking to the future, as the era of “personalized medicine” progresses, panels of biomarkers that stratify baseline fertility potential and posttreatment infertility risk will further facilitate clinical decision-making for both healthcare providers and their patients.

Keywords

  • Biological biomarker
  • Fertility
  • Fertility preservation
  • Follicle-stimulating hormone
  • Infertility
  • Neoplasm
  • Testis
  • Testosterone
  • Semen analysis
  • Spermatogenesis

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Abbreviations

AMH:

Anti-Müllerian hormone

ASCO:

American Society of Clinical Oncology

DSDs:

Disorders of sexual development

FSH:

Follicle-stimulating hormone

GnRH:

Gonadotropin-releasing hormone

HPG:

Hypothalamic-pituitary-gonadal

LH:

Luteinizing hormone

WHO:

World Health Organization

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Correspondence to James A. Kashanian MD .

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Kashanian, J.A., Brannigan, R.E. (2017). Assessing Testicular Reserve in the Male Oncology Patient. In: Woodruff, T., Gosiengfiao, Y. (eds) Pediatric and Adolescent Oncofertility. Springer, Cham. https://doi.org/10.1007/978-3-319-32973-4_9

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  • DOI: https://doi.org/10.1007/978-3-319-32973-4_9

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