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Gulino G, Distante A, Akhundov A, Bassi PF. Male infertility and urological tumors: Pathogenesis and therapeutical implications. Urologia 2023; 90:622-630. [PMID: 37491831 PMCID: PMC10623618 DOI: 10.1177/03915603221146147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/22/2022] [Indexed: 07/27/2023]
Abstract
Most genitourinary tract cancers have a negative impact on male fertility. Although testicular cancers have the worst impact, other tumors such as prostate, bladder, and penis are diagnosed early and treated in relatively younger patients in which couple fertility can be an important concern. The purpose of this review is to highlight both the pathogenetic mechanisms of damage to male fertility in the context of the main urological cancers and the methods of preserving male fertility in an oncological setting, in light of the most recent scientific evidence. A systematic review of available literature was carried out on the main scientific search engines, such as PubMed, Clinicaltrials.Gov, and Google scholar. Three hundred twenty-five relevant articles on this subject were identified, 98 of which were selected being the most relevant to the purpose of this review. There is a strong evidence in literature that all of the genitourinary oncological therapies have a deep negative impact on male fertility: orchiectomy, partial orchiectomy, retroperitoneal lymphadenectomy (RPLND), radical cystectomy, prostatectomy, penectomy, as well as radiotherapy, chemotherapy, and hormonal androgen suppression. Preservation of fertility is possible and includes cryopreservation, hormonal manipulation with GnRH analogs before chemotherapy, androgen replacement. Germ cell auto transplantation is an intriguing strategy with future perspectives. Careful evaluation of male fertility must be a key point before treating genitourinary tumors, taking into account patients' age and couples' perspectives. Informed consent should provide adequate information to the patient about the current state of his fertility and about the balance between risks and benefits in oncological terms. Standard approaches to genitourinary tumors should include a multidisciplinary team with urologists, oncologists, radiotherapists, psycho-sexologists, andrologists, gynecologists, and reproductive endocrinologists.
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Affiliation(s)
- G Gulino
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Distante
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Akhundov
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - PF Bassi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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2
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Masliukaite I, Ntemou E, Feijen EAM, van de Wetering M, Meissner A, Soufan AT, Repping S, Kremer LMC, Jahnukainen K, Goossens E, van Pelt AMM. Childhood cancer and hematological disorders negatively affect spermatogonial quantity at diagnosis: a retrospective study of a male fertility preservation cohort. Hum Reprod 2023; 38:359-370. [PMID: 36708005 PMCID: PMC9977127 DOI: 10.1093/humrep/dead004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/20/2022] [Indexed: 01/29/2023] Open
Abstract
STUDY QUESTION What is the impact of cancer or hematological disorders on germ cells in pediatric male patients? SUMMARY ANSWER Spermatogonial quantity is reduced in testes of prepubertal boys diagnosed with cancer or severe hematological disorder compared to healthy controls and this reduction is disease and age dependent: patients with central nervous system cancer (CNS tumors) and hematological disorders, as well as boys <7 years are the most affected. WHAT IS KNOWN ALREADY Fertility preservation in pediatric male patients is considered based on the gonadotoxicity of selected treatments. Although treatment effects on germ cells have been extensively investigated, limited data are available on the effect of the disease on the prepubertal male gonad. Of the few studies investigating the effects of cancer or hematologic disorders on testicular function and germ cell quantity in prepuberty, the results are inconsistent. However, recent studies suggested impairments before the initiation of known gonadotoxic therapy. Understanding which diseases and at what age affect the germ cell pool in pediatric patients before treatment is critical to optimize strategies and counseling for fertility preservation. STUDY DESIGN, SIZE, DURATION This multicenter retrospective cohort study included 101 boys aged <14 years with extra-cerebral cancer (solid tumors), CNS tumors, leukemia/lymphoma (blood cancer), or non-malignant hematological disorders, who were admitted for a fertility preservation programme between 2002 and 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS In addition to clinical data, we analyzed measurements of testicular volume and performed histological staining on testicular biopsies obtained before treatment, at cryopreservation, to evaluate number of spermatogonia per tubular cross-section, tubular fertility index, and the most advanced germ cell type prior to chemo-/radiotherapy. The controls were data simulations with summary statistics from original studies reporting healthy prepubertal boys' testes characteristics. MAIN RESULTS AND THE ROLE OF CHANCE Prepubertal patients with childhood cancer or hematological disorders were more likely to have significantly reduced spermatogonial quantity compared to healthy controls (48.5% versus 31.0% prevalence, respectively). The prevalence of patients with reduced spermatogonial quantity was highest in the CNS tumor (56.7%) and the hematological disorder (55.6%) groups, including patients with hydroxyurea pre-treated sickle cell disease (58.3%) and patients not exposed to hydroxyurea (50%). Disease also adversely impacted spermatogonial distribution and differentiation. Irrespective of disease, we observed the highest spermatogonial quantity reduction in patients <7 years of age. LIMITATIONS, REASONS FOR CAUTION For ethical reasons, we could not collect spermatogonial quantity data in healthy prepubertal boys as controls and thus deployed statistical simulation on data from literature. Also, our results should be interpreted considering low patient numbers per (sub)group. WIDER IMPLICATIONS OF THE FINDINGS Cancers, especially CNS tumors, and severe hematological disorders can affect spermatogonial quantity in prepubertal boys before treatment. Consequently, these patients may have a higher risk of depleted spermatogonia following therapies, resulting in persistent infertility. Therefore, patient counseling prior to disease treatment and timing of fertility preservation should not only be based on treatment regimes, but also on diagnoses and age. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by Marie Curie Initial Training Network (ITN) (EU-FP7-PEOPLE-2013-ITN) funded by European Commision grant no. 603568; ZonMW Translational Adult stem cell research (TAS) grant no. 116003002. No competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Ieva Masliukaite
- Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Research Institute Amsterdam Reproduction & Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Elissavet Ntemou
- Biology of the Testis Lab, Department of Reproduction, Genetics and Regenerative Medicine, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | | | - Andreas Meissner
- Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Alexandre T Soufan
- Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sjoerd Repping
- Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- The National Health Care Institute, Diemen, The Netherlands
| | - Leontien M C Kremer
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Kirsi Jahnukainen
- NORDFERTIL Research Lab Stockholm, Department of Women’s and Children’s Health, Karolinska Institutet and University Hospital, Stockholm, Sweden
- New Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ellen Goossens
- Biology of the Testis Lab, Department of Reproduction, Genetics and Regenerative Medicine, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ans M M van Pelt
- Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Research Institute Amsterdam Reproduction & Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Kitlinski M, Giwercman A, Elenkov A. Paternity through use of assisted reproduction technology in male adult and childhood cancer survivors: a nationwide register study. Hum Reprod 2023; 38:973-981. [PMID: 36773319 DOI: 10.1093/humrep/dead026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/15/2023] [Indexed: 02/13/2023] Open
Abstract
STUDY QUESTION How does a history of cancer affect the likelihood of using assisted reproduction in order to achieve paternity? SUMMARY ANSWER As compared to men with no history of cancer, use of assisted reproduction to achieve paternity was more frequent in fathers with a history of cancer, mainly those with testicular, prostate, and hematological and lymphatic malignancies. WHAT IS KNOWN ALREADY Although it is well known that different types of cancer and their treatment may have a negative impact on fertility, there is a lack of data regarding the use of IVF and ICSI among male cancer survivors. STUDY DESIGN, SIZE, DURATION In this population-based nation-wide study using the Swedish Medical Birth Register, we identified all men who fathered their first-born child in Sweden between 1994 and 2014. Using personal identification numbers, anonymized data from the Swedish National Quality of Assisted Reproduction Register, Swedish Cancer Register, Swedish Multi-generation Register, and Swedish Education Register were linked with the Swedish Medical Birth Register. PARTICIPANTS/MATERIALS, SETTING, METHODS During the study period, a total of 1 181 488 men fathering their first-born child were identified. Of these, 26 901 fathers had a cancer diagnosis. Fathers diagnosed with cancer with <12 months from offspring conception, or with a cancer diagnosis after offspring conception, were excluded (n = 21 529). The remaining fathers who had a history of cancer (n = 5372) were divided into three groups based on age at cancer diagnosis (<15, ≥15 and <24, or ≥24 years). For subgroup analyses, they were also grouped according to the cancer location using ICD-7 codes. The fathers with no cancer diagnosis (n = 1 154 587), were included as controls. In total, 1 159 959 men were included. Associations between IVF/ICSI use and history of cancer were evaluated using logistic regression models, unadjusted and adjusted for paternal education, fathers age at childbirth, and year of conception, yielding crude and adjusted odds ratio (aOR), respectively, with a 95% CI. MAIN RESULTS AND THE ROLE OF CHANCE As compared to controls, childhood cancer survivors were only more likely to achieve paternity through ICSI (aOR 3.52, 95% CI 2.52-4.93; P < 0.001) but not through IVF treatment (aOR 1.02, 95% CI 0.61-1.70; P = 0.955). Similarly, teenage and young adult cancer survivors were more likely to father through ICSI treatment (aOR 6.84, 95% CI 5.64-8.30; P < 0.001) but not using IVF (aOR 1.27, 95% CI 0.90-1.80; P = 0.17). However, adult cancer survivors were more likely to conceive through either ICSI (aOR 5.52, 95% CI 4.86-6.27; P < 0.001) or IVF treatment (aOR 1.32, 95% CI 1.09-1.60; P = 0.004). In subgroup analyses, childhood survivors of testicular cancer (aOR 5.15, 95% CI 1.20-22.0; P = 0.027), soft tissue and bone cancers (aOR 4.70, 2.13-10.4; P < 0.001), hematological and lymphatic cancers (aOR 4.49, 95% CI 2.72-7.40; P < 0.001), or central nervous system (CNS) and eye cancers (aOR 2.64, 95% CI 1.23-5.67; P = 0.012), were at an increased likelihood of fathering through ICSI. Teenage and young adult survivors of testicular cancer (aOR 15.4, 95% CI 11.5-20.7; P < 0.001), hematological and lymphatic cancers (aOR 9.84, 95% CI 6.93-14.0; P < 0.001), or soft tissue and bone cancers (aOR 6.83, 95% CI 3.53-13.2; P < 0.001) were more likely to father through ICSI treatment. Adult survivors of prostate cancer (aOR 15.7, 95% CI 6.70-36.9; P < 0.001), testicular cancer (aOR 9.54, 95% CI 7.81-11.7; P < 0.001), hematological and lymphatic cancers (aOR 11.3, 95% CI 8.63-14.9; P < 0.001), digestive, respiratory, and urogenital tract cancers (aOR 2.62, 95% CI 1.75-3.92; P < 0.001), CNS and eye cancers (aOR 2.74, 95% CI 1.48-5.08; P = 0.001), or skin cancer (aOR 1.68, 95% CI 1.08-2.62; P = 0.022) were more likely to father through ICSI treatment. Only teenage and young adult survivors of hematological and lymphatic cancers (aOR 1.98, 95% CI 1.10-3.56; P = 0.022) and adult survivors of testicular cancer (aOR 1.88, 95% CI 1.37-2.58; P < 0.001) were significantly more likely to achieve fatherhood using IVF treatment. LIMITATIONS, REASONS FOR CAUTION Information on men failing to father children was not available, and thus our results cannot estimate the risk of infertility in men with a history of cancer. WIDER IMPLICATIONS OF THE FINDINGS Use of ART, in particular ICSI, was significantly more frequent in fathers with malignancies of the male reproductive tract or hematological and lymphatic systems. Our findings highlight which groups of male cancer survivors would benefit from access to fertility care, thereby improving future fertility treatment policies. STUDY FUNDING/COMPETING INTEREST(S) The study received funding from the Swedish Cancer Society, Swedish Childhood Cancer Society, and the Swedish Government Fund for Clinical Research. There are no competing interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Michael Kitlinski
- Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.,Department of Translational Medicine, Clinical Research Centre, Lund University, Malmö, Sweden
| | - Aleksander Giwercman
- Department of Translational Medicine, Clinical Research Centre, Lund University, Malmö, Sweden.,Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden
| | - Angel Elenkov
- Department of Translational Medicine, Clinical Research Centre, Lund University, Malmö, Sweden.,Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden
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Inflammatory Modulation of miR-155 Inhibits Doxorubicin-Induced Testicular Dysfunction via SIRT1/FOXO1 Pathway: Insight into the Role of Acacetin and Bacillus cereus Protease. Appl Biochem Biotechnol 2022; 194:5196-5219. [PMID: 35715546 PMCID: PMC9587093 DOI: 10.1007/s12010-022-03992-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 12/02/2022]
Abstract
Doxorubicin (DOX) is a chemotherapeutic agent that can disrupt testicular function leading to male infertility. This study examined the protective role of natural flavone, acacetin (ACA), and a protease of Bacillus cereus bacteria (B. cereus) as well as the potential role of miR-155/SIRT1/FOXO1 network in DOX-induced testicular injury. Twenty-four male Wistar rats were randomly allocated into four groups and treated as follows: Control, DOX (1 mg/kg, i.p) every other day for 21 days with a total dose equal to 10 mg/kg throughout the experiment, and pre-treated groups that received ACA (5 mg/kg/day, p.o) or B. cereus protease (36 mg/kg/day, p.o) for a week prior to DOX administration. DOX challenge reduced the testis weight coefficient, serum testosterone, and testicular 17β-hydroxysteroid dehydrogenase (17β-HSD). DOX caused a significant increase in testicular oxidative stress, inflammatory, and apoptotic markers. Aberrant testicular miR-34c, a germ-specific miRNA, and miR-155 expressions were observed, along with decreased protein expression of sirtuin1 (SIRT1) dependent forkhead box 1 (FOXO1) acetylation which induces apoptosis. Besides, abnormal histopathological architecture and a marked reduction in the testicular expression of proliferating cell nuclear antigen (PCNA) were observed. ACA or protease administration significantly improved the histopathological and immunohistochemical pictures compared with DOX alone and renovated testicular functions. Interestingly, treatment with protease was more significant than treatment with ACA in ameliorating DOX-induced testicular injury. Taken together, this study reveals the prophylactic role of these two regimens on male fertility by exhibiting antioxidant, anti-inflammatory, and anti-apoptotic effects against DOX-elicited testicular damage, possibly via modulating miR-155/SIRT1/FOXO1 network.
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5
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Applications of Focused Ultrasound in the Treatment of Genitourinary Cancers. Cancers (Basel) 2022; 14:cancers14061536. [PMID: 35326687 PMCID: PMC8945954 DOI: 10.3390/cancers14061536] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Cancer is a prevalent disease globally, and conventional treatment options have been associated with substantial morbidity for patients. The unique acoustic properties and biological effects of focused ultrasound have been investigated for use as an alternative treatment option for various forms of cancer with lower associated morbidity than standard treatments. The objective of our review was to assess the current state and various applications of focused ultrasound for the treatment of genitourinary cancers, including prostate, kidney, bladder, penile, and testicular malignancies. Current research demonstrates that focused ultrasound-based focal therapy shows promise for the treatment of localized prostate and kidney cancer, and the effect of ultrasound on cell membranes may increase the efficacy of chemotherapeutics and radiotherapy. Focused ultrasound-based treatment modalities should continue to be investigated as an alternative or complementary treatment option for cancer patients. Abstract Traditional cancer treatments have been associated with substantial morbidity for patients. Focused ultrasound offers a novel modality for the treatment of various forms of cancer which may offer effective oncological control and low morbidity. We performed a review of PubMed articles assessing the current applications of focused ultrasound in the treatment of genitourinary cancers, including prostate, kidney, bladder, penile, and testicular cancer. Current research indicates that high-intensity focused ultrasound (HIFU) focal therapy offers effective short-term oncologic control of localized prostate and kidney cancer with lower associated morbidity than radical surgery. In addition, studies in mice have demonstrated that focused ultrasound treatment increases the accuracy of chemotherapeutic drug delivery, the efficacy of drug uptake, and cytotoxic effects within targeted cancer cells. Ultrasound-based therapy shows promise for the treatment of genitourinary cancers. Further research should continue to investigate focused ultrasound as an alternative cancer treatment option or as a complement to increase the efficacy of conventional treatments such as chemotherapy and radiotherapy.
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6
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Montano L, Maugeri A, Volpe MG, Micali S, Mirone V, Mantovani A, Navarra M, Piscopo M. Mediterranean Diet as a Shield against Male Infertility and Cancer Risk Induced by Environmental Pollutants: A Focus on Flavonoids. Int J Mol Sci 2022; 23:ijms23031568. [PMID: 35163492 PMCID: PMC8836239 DOI: 10.3390/ijms23031568] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023] Open
Abstract
The role of environmental factors in influencing health status is well documented. Heavy metals, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls, dioxins, pesticides, ultrafine particles, produced by human activities put a strain on the body’s entire defense system. Therefore, together with public health measures, evidence-based individual resilience measures are necessary to mitigate cancer risk under environmental stress and to prevent reproductive dysfunction and non-communicable diseases; this is especially relevant for workers occupationally exposed to pollutants and/or populations residing in highly polluted areas. The Mediterranean diet is characterized by a high intake of fruits and vegetables rich in flavonoids, that can promote the elimination of pollutants in tissues and fluids and/or mitigate their effects through different mechanisms. In this review, we collected evidence from pre-clinical and clinical studies showing that the impairment of male fertility and gonadal development, as well as cancers of reproductive system, due to the exposure of organic and inorganic pollutants, may be counteracted by flavonoids.
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Affiliation(s)
- Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL), 84124 Salerno, Italy;
- PhD Program in Evolutionary Biology and Ecology, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Alessandro Maugeri
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
| | - Maria Grazia Volpe
- Institute of Food Sciences, National Research Council, CNR, 83100 Avellino, Italy;
| | - Salvatore Micali
- Urology Department, University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Vincenzo Mirone
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80126 Naples, Italy;
| | - Alberto Mantovani
- Department of Food, Safety, Nutrition and Veterinary public health, Italian National Health Institute, 00161 Roma, Italy;
| | - Michele Navarra
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
- Correspondence:
| | - Marina Piscopo
- Department of Biology, University of Naples Federico II, 80126 Napoli, Italy;
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Harada M, Kimura F, Takai Y, Nakajima T, Ushijima K, Kobayashi H, Satoh T, Tozawa A, Sugimoto K, Saji S, Shimizu C, Akiyama K, Bando H, Kuwahara A, Furui T, Okada H, Kawai K, Shinohara N, Nagao K, Kitajima M, Suenobu S, Soejima T, Miyachi M, Miyoshi Y, Yoneda A, Horie A, Ishida Y, Usui N, Kanda Y, Fujii N, Endo M, Nakayama R, Hoshi M, Yonemoto T, Kiyotani C, Okita N, Baba E, Muto M, Kikuchi I, Morishige KI, Tsugawa K, Nishiyama H, Hosoi H, Tanimoto M, Kawai A, Sugiyama K, Boku N, Yonemura M, Hayashi N, Aoki D, Osuga Y, Suzuki N. Japan Society of Clinical Oncology Clinical Practice Guidelines 2017 for fertility preservation in childhood, adolescent, and young adult cancer patients: part 1. Int J Clin Oncol 2022; 27:265-280. [PMID: 34973107 PMCID: PMC8816532 DOI: 10.1007/s10147-021-02081-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022]
Abstract
In 2017, the Japan Society of Clinical Oncology (JSCO) published the JSCO Clinical Practice Guidelines 2017 for Fertility Preservation in Childhood, Adolescent, and Young Adult Cancer Patients. These were the first Japanese guidelines to address issues of oncofertility. In this field of medicine, sustained close cooperation between oncologists and reproductive specialists is essential from the diagnosis of cancer until many years after completion of cancer treatment. These JSCO guidelines were intended to guide multidisciplinary medical staff in considering the availability of fertility preservation options and to help them decide whether to provide fertility preservation to childhood, adolescent, and young adult cancer patients before treatment starts, with the ultimate goal of improving patient survivorship. The guidelines are presented as Parts 1 and 2. This article (Part 1) summarizes the goals of the guidelines and the methods used to develop them and provides an overview of fertility preservation across all oncology areas. It includes general remarks on the basic concepts surrounding fertility preservation and explanations of the impacts of cancer treatment on gonadal function by sex and treatment modality and of the options for protecting/preserving gonadal function and makes recommendations based on 4 clinical questions. Part 2 of these guidelines provides specific recommendations on fertility preservation in 8 types of cancer (gynecologic, breast, urologic, pediatric, hematologic, bone and soft tissue, brain, and digestive).
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Affiliation(s)
- Miyuki Harada
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Fuminori Kimura
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Seta Tsukinowa-Cho Otsu, Shiga, 520-2192, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe City, Saitama, 350-3550, Japan
| | - Takeshi Nakajima
- Department of Endoscopy, Gastrointestinal Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroaki Kobayashi
- Department of Obstetrics and Gynecology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Akiko Tozawa
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan
| | - Kohei Sugimoto
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, 1 Hikarigaoka, Fukushima-city, Fukushima, 960-1295, Japan
| | - Chikako Shimizu
- Department of Breast and Medical Oncology, Comprehensive Cancer Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kyoko Akiyama
- Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan
| | - Hiroko Bando
- Department of Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Akira Kuwahara
- Ladies Clinic Cosmos Kochi, 6-27, Sugiiru, Kochi, Kochi, 780-0082, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, 1-1, Yanagido, Gifu City, Gifu, 501-1194, Japan
| | - Hiroshi Okada
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Koji Kawai
- Department of Urology, International University of Health and Welfare, 852, Hatakeda Narita, Chiba, 286-0124, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, Kita 15Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Koichi Nagao
- Department of Urology, Toho University Faculty of Medicine, 6-11-1, Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Michio Kitajima
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Souichi Suenobu
- Division of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan
| | - Toshinori Soejima
- Department of Radiation Oncology, Kobe Proton Center, 1-6-8, Minatojima-minamimachi, Chuo-ku, Kobe City, Hyogo, 650-0047, Japan
| | - Mitsuru Miyachi
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoko Miyoshi
- Department of Health and Nutrition, Faculty of Health and Nutrition, Osaka Shoin Women's University, 4-2-26 Hishiya-nishi, Higashi-Osaka, Osaka, 577-8550, Japan
| | - Akihiro Yoneda
- Division of Pediatric Surgical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akihito Horie
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Yasushi Ishida
- Pediatric Medical Center, Ehime Prefectural Central Hospital, 83 Kasuga-machi, Matsuyama-city, Ehime, 790-0024, Japan
| | - Noriko Usui
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Department of Medicine, Jichi Medical University, 1-847 Amanuma, Omiya-ku, Saitama-city, Saitama, 330-8503, Japan
| | - Nobuharu Fujii
- Division of Transfusion, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Makoto Endo
- Department of Orthopaedic Surgery, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Robert Nakayama
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Manabu Hoshi
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Tsukasa Yonemoto
- Division of Orthopedic Surgery, Chiba Cancer Center, 666-2 Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Natsuko Okita
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Eishi Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Iwaho Kikuchi
- Department of Obstetrics and Gynecology, Medical Park Yokohama, 1-1-8, Sakuragi-cho, Yokohama, Kanagawa, 231-0062, Japan
| | - Ken-Ichirou Morishige
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, 1-1, Yanagido, Gifu City, Gifu, 501-1194, Japan
| | - Koichiro Tsugawa
- Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hajime Hosoi
- Department of Nursing, Doshisha Women's College of Liberal Arts, Kodo, Kyotanabe City, Kyoto, 610-0395, Japan
| | - Mitsune Tanimoto
- Chugoku Central Hospital, 148-13, Kamiiwanari, Miyuki-cho, Fukuyama-city, Hiroshima, 720-0001, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology and Rehabilitation Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kazuhiko Sugiyama
- Department of Clinical Oncology and Neuro-Oncology Program, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Narikazu Boku
- Department of Medical Oncology and General Medicine, Institute of Medical Science, IMSUT Hospital, University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Masato Yonemura
- Department of Pharmacy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-0882, Japan
| | - Naoko Hayashi
- Graduate School of Nursing Science, St Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan
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Blecher GA, Chung E, Katz D, Kim SHK, Bailie J. Onco-Testicular Sperm Extraction (oncoTESE): A Contemporary Concept Review and Report of Australian Sperm Retrieval Rates and Fertility Outcomes. Urology 2021; 160:109-116. [PMID: 34813838 DOI: 10.1016/j.urology.2021.10.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess sperm retrieval rates of Onco-Testicular Sperm Extraction (oncoTESE) in men with testicular tumors and coexisting severe spermatogenic impairment. METHODS Multi-centre Australian wide retrospective review of oncoTESE procedures performed within the last 10 years. Patients were postpubertal adults having a testicular tumor requiring orchidectomy, with severe oligozoospermia or nonobstructive azoospermia. Ipsilateral testicular sperm extraction was performed following radical inguinal orchidectomy. A contralateral micro-testicular sperm extraction was performed if no sperm or insufficient amounts were initially achieved. Surgical sperm retrieval rates, live birth rates and post operative serum testosterone were recorded. RESULTS Four surgeons compiled a total 13 patients. The mean age was 34.9 years. Seven of 13 were germ cell tumor (GCT), 4 of 13 had non-GCT and 2 of 13 contained benign lesions. Twelve of 13 patients were azoospermic and 1 was severely oligozoospermic. Sperm was found in 6 of 7 GCT patients; 3 of 7 were found in the ipsilateral testis whilst the remaining 4 underwent contralateral micro-testicular sperm extraction; sperm was retrieved in 3 of 4. The respective mean pre and post orchidectomy testosterone was 12.0 vs 14.1nmol/L (GCT cohort). Cryopreserved sperm has been used in assisted reproduction in 2 of 13 patients, with median follow up of 38.7 months. Including use of both cryopreserved and fresh sperm, 6 pregnancies were achieved, including 5 healthy live births and 1 miscarriage. CONCLUSION OncoTESE appears feasible, with acceptable sperm retrieval and subsequent live birth rates, following assisted reproduction. Despite significant underutilisation in the Australian population, oncoTESE should be considered in the management for TC patients with severe oligozoospermia, or nonobstructive azoospermia.
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Affiliation(s)
- Gideon Adam Blecher
- School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Department of Urology, Alfred Health, Melbourne, Victoria, Australia; Department of Urology, Monash Health, Melbourne, Victoria, Australia.
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia; AndroUrology Centre, St Andrew's War Memorial Hospital, Brisbane, Queensland, Australia
| | - Darren Katz
- Department of Urology, Western Health, Melbourne, Victoria, Australia; Men's Health, Melbourne, Victoria, Australia
| | - Shannon Hee Kyung Kim
- IVF Australia, Sydney, New South Wales, Australia; Macquaire University, Macquarie school of medicine, Sydney, New South Wales, Australia
| | - John Bailie
- Department of Urology, Monash Health, Melbourne, Victoria, Australia
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9
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Verdonck-de Leeuw IM, Melissant H, Lissenberg-Witte BI, Baatenburg de Jong RJ, den Heijer M, Langendijk JA, René Leemans C, Smit JH, Takes RP, Terhaard CHJ, Jansen F, Laan E. Associations between testosterone and patient reported sexual outcomes among male and female head and neck cancer patients before and six months after treatment: A pilot study. Oral Oncol 2021; 121:105505. [PMID: 34461364 DOI: 10.1016/j.oraloncology.2021.105505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/30/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To investigate associations between testosterone and patient reported sexual problems and need for sexual care in head and neck cancer patients at time of diagnosis and 6 months after treatment. PATIENTS AND METHODS Data and samples were used of 40 patients (20 men, 20 women) before and 6 months after treatment. Outcome measures were total testosterone level (TT) and free testosterone index (FTI), testosterone insufficiency (TI), the EORTC QLQ-HN35 Sexuality subscale, the subscales of the International Index of Erectile Function (IIEF), Female Sexual Function Index (FSFI), and the Sexuality subscale of the Short-Form Supportive Care Needs Survey (SCNS-SF34). RESULTS In men, higher FTI before treatment was significantly associated with better IIEF Orgasm (p = 0.020) and at 6 months follow-up with IIEF Desire (p = 0.019). Before treatment, insufficient testosterone was present in 5 males (25%) and in 3 at follow-up (15%) (2 patients who had TI before treatment plus one). In women, higher TT at follow-up was significantly associated with better EORTC Sexuality (p = 0.031) and FSFI Satisfaction (p = 0.020); FTI at follow-up was associated with FSFI Satisfaction (p = 0.012). Before treatment, TI was present in 2 women (10%) and in 3 (15%) at follow-up (the same 2 patients plus one). CONCLUSION This pilot study showed that testosterone seems to be associated with patient reported sexual outcomes among male and female head and neck cancer patients. It is estimated that 10-25% of HNC patients may have testosterone insufficiency before treatment and/or at 6 months after treatment.
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Affiliation(s)
- Irma M Verdonck-de Leeuw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands; Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Heleen Melissant
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Birgit I Lissenberg-Witte
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam, the Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus MC, Rotterdam, the Netherlands
| | - Martin den Heijer
- Department of Internal Medicine, AmsterdamUMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Johannes A Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - C René Leemans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Johannes H Smit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Robert P Takes
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center, Utrecht, the Netherlands
| | - Femke Jansen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ellen Laan
- Department of Sexology and Psychosomatic OBGYN, Amsterdam Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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Chang T, Zhao G. Ice Inhibition for Cryopreservation: Materials, Strategies, and Challenges. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:2002425. [PMID: 33747720 PMCID: PMC7967093 DOI: 10.1002/advs.202002425] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/15/2020] [Indexed: 05/14/2023]
Abstract
Cryopreservation technology has developed into a fundamental and important supporting method for biomedical applications such as cell-based therapeutics, tissue engineering, assisted reproduction, and vaccine storage. The formation, growth, and recrystallization of ice crystals are the major limitations in cell/tissue/organ cryopreservation, and cause fatal cryoinjury to cryopreserved biological samples. Flourishing anti-icing materials and strategies can effectively regulate and suppress ice crystals, thus reducing ice damage and promoting cryopreservation efficiency. This review first describes the basic ice cryodamage mechanisms in the cryopreservation process. The recent development of chemical ice-inhibition molecules, including cryoprotectant, antifreeze protein, synthetic polymer, nanomaterial, and hydrogel, and their applications in cryopreservation are summarized. The advanced engineering strategies, including trehalose delivery, cell encapsulation, and bioinspired structure design for ice inhibition, are further discussed. Furthermore, external physical field technologies used for inhibiting ice crystals in both the cooling and thawing processes are systematically reviewed. Finally, the current challenges and future perspectives in the field of ice inhibition for high-efficiency cryopreservation are proposed.
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Affiliation(s)
- Tie Chang
- Department of Electronic Science and TechnologyUniversity of Science and Technology of ChinaHefeiAnhui230027China
| | - Gang Zhao
- Department of Electronic Science and TechnologyUniversity of Science and Technology of ChinaHefeiAnhui230027China
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11
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Su JS, Farber NJ, Cai Y, Doolittle J, Gupta S, Agarwal A, Vij SC. Assessing online price transparency of sperm cryopreservation across the United States. Andrologia 2021; 53:e13957. [PMID: 33398891 DOI: 10.1111/and.13957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/13/2020] [Accepted: 12/19/2020] [Indexed: 11/29/2022] Open
Abstract
Although the lack of information on the costs and pricing of healthcare services prevails throughout the medical industry, empiric observations have demonstrated that pricing information is even more obscured in the sperm cryopreservation market. Thus, the objectives of our study are to assess and compare online price transparency and the price of sperm cryopreservation across various healthcare settings in the United States. This study examined online pricing published by facilities that have an active registration to store spermatozoa with the Food and Drug Administration. Less than one-fifth of registered facilities display any pricing information online. Price transparency also varies among census regions and facility types. Nationally, the median initial bank fee and annual price of storage are $350 and $385 respectively. Although there were no differences in the initial fee by facility type and census region, the annual price of storing spermatozoa is highest in the Northeast, which could be attributed to laboratory techniques, demographic patterns or insurance coverage. Guidelines from professional societies or different legislation and regulatory requirements across different US states can increase price transparency, which can promote consumer decision-making and decrease the barrier for men seeking fertility preservation.
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Affiliation(s)
- Johnny S Su
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Nicholas J Farber
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Yida Cai
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Johnathan Doolittle
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sajal Gupta
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Sarah C Vij
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
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12
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Cai Q, Chen Y, Zhang D, Pan J, Xie Z, Xu C, Li S, Zhang X, Gao Y, Hou J, Guo X, Zhou X, Zhang B, Ma F, Zhang W, Lin G, Xin Z, Niu Y, Wang Y. Estimates of over-time trends in incidence and mortality of testicular cancer from 1990 to 2030. Transl Androl Urol 2020; 9:182-195. [PMID: 32420124 PMCID: PMC7215014 DOI: 10.21037/tau.2020.02.22] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background This study aims to explore and project the temporal trends in incidence and mortality of testicular cancer. Moreover, it can provide theoretical guidance for the rational allocation of health resources. Methods This study analyzed existing data on testicular cancer morbidity and mortality from 1990 to 2016 and predicted time-varying trends of age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) from 2017 to 2030 in different ages, regions and sociodemographic index (SDI) quintile sub-groups. Result Globally, numbers of testicular cancer cases in 2016 [66,833; 95% uncertainty interval (UI), 64,487–69,736] are 1.8 times larger than in 1990 (37,231; 95% UI, 36,116–38,515). The testicular cancer-related death cases increased slightly from 8,394 (95% UI, 7,980–8,904) in 1990 to 8,651 (95% UI, 8,292–9,027) in 2016. In aspect of ASIR, the data showed an up-trend from 0.74 (95% UI, 0.72–0.77) in 1990 to 0.88 (95% UI, 0.85–0.92) in 2016. The ASDR of testicular cancer declined from 0.18 (95% UI, 0.17–0.19) in 1990 to 0.12 (95% UI, 0.11–0.12) in 2016. From 2017 to 2030, predictions of trends in testicular cancer indicate that the ASIRs of most SDI countries are rising, but the ASDRs trends in testicular cancer will decrease. Conclusions By analyzing the available and reliable data in different ages, regions and SDI, this study shows a significant upward trend in incidence and a slow upward trend in mortality of testicular cancer from 1990 to 2016, and simultaneously, predicts the increase of ASIR and the downward trend of ASDR in 2017–2030.
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Affiliation(s)
- Qiliang Cai
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China.,School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yegang Chen
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Dingrong Zhang
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Jiancheng Pan
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Zunke Xie
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Chenjie Xu
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Shu Li
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Ying Gao
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jie Hou
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Xuemei Guo
- Library of Tianjin Medical University, Tianjin Medical University, Tianjin 300070, China
| | - Xiaodong Zhou
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Baoshuai Zhang
- Scientific Research Department, the Second Hospital of Tianjin Medical University, Tianjin 300070, China
| | - Fei Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Wei Zhang
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Guiting Lin
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Zhongcheng Xin
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China.,Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China
| | - Yuanjie Niu
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
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13
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Klipstein S, Fallat ME, Savelli S. Fertility Preservation for Pediatric and Adolescent Patients With Cancer: Medical and Ethical Considerations. Pediatrics 2020; 145:peds.2019-3994. [PMID: 32071259 DOI: 10.1542/peds.2019-3994] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Many cancers presenting in children and adolescents are curable with surgery, chemotherapy, and/or radiotherapy. Potential adverse consequences of treatment include sterility, infertility, or subfertility as a result of gonad removal, damage to germ cells as a result of adjuvant therapy, or damage to the pituitary and hypothalamus or uterus as a result of irradiation. In recent years, treatment of solid tumors and hematologic malignancies has been modified in an attempt to reduce damage to the gonadal axis. Simultaneously, advances in assisted reproductive technology have led to new possibilities for the prevention and treatment of infertility. This clinical report reviews the medical aspects and ethical considerations that arise when considering fertility preservation in pediatric and adolescent patients with cancer.
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Affiliation(s)
- Sigal Klipstein
- Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois; .,InVia Fertility Specialists, Chicago, Illinois
| | - Mary E Fallat
- Division of Pediatric Surgery, Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, Kentucky; and
| | - Stephanie Savelli
- Division of Pediatric Hematology/Oncology, Akron Children's Hospital, Akron, Ohio
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14
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Rabaça A, Ferreira C, Bernardino R, Alves M, Oliveira P, Viana P, Barros A, Sousa M, Sá R. Use of antioxidant could ameliorate the negative impact of etoposide on human sperm DNA during chemotherapy. Reprod Biomed Online 2020; 40:856-866. [PMID: 32376314 DOI: 10.1016/j.rbmo.2020.01.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 12/31/2019] [Accepted: 01/30/2020] [Indexed: 01/07/2023]
Abstract
RESEARCH QUESTION A previous study showed that N-acetylcysteine (NAC), used after in-vitro exposure to the gonadotoxic chemotherapeutic drug etoposide, has the ability to decrease DNA damage in human spermatozoa; however, it showed no benefit when used before exposure. This study aimed to evaluate the impact of the NAC on the preservation of sperm quality during in-vitro exposure to etoposide. DESIGN Twenty semen samples were submitted to four experimental conditions: control, NAC-only incubation, etoposide-only incubation, and concomitant etoposide and NAC incubation. After in-vitro incubation, semen parameters, sperm chromatin condensation, sperm DNA fragmentation, sperm oxidative stress and sperm metabolism were used to evaluate the role of NAC in protecting human spermatozoa from etoposide. RESULTS Etoposide did not affect semen parameters, nor did it cause sperm oxidative damage or alterations in glycolytic profile. However, it induced chromatin decondensation and DNA fragmentation, which were fully prevented by NAC. CONCLUSIONS NAC was able to protect sperm DNA integrity during etoposide treatment in vitro, suggesting that NAC may be useful as an adjuvant agent in preserving male fertility during chemotherapy treatments.
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Affiliation(s)
- Ana Rabaça
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Porto, Portugal
| | - Carolina Ferreira
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Porto, Portugal
| | - Raquel Bernardino
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal
| | - Marco Alves
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal
| | - Pedro Oliveira
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Porto, Portugal; Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal; Health Institute of Research and Innovation (IPATIMUP/i3S), University of Porto, Porto, Portugal
| | - Paulo Viana
- Centre for Reproductive Genetics A. Barros (CGR), Porto, Portugal
| | - Alberto Barros
- Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal; Health Institute of Research and Innovation (IPATIMUP/i3S), University of Porto, Porto, Portugal; Centre for Reproductive Genetics A. Barros (CGR), Porto, Portugal
| | - Mário Sousa
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal.
| | - Rosália Sá
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal
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15
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Parekh NV, Lundy SD, Vij SC. Fertility considerations in men with testicular cancer. Transl Androl Urol 2020; 9:S14-S23. [PMID: 32055481 DOI: 10.21037/tau.2019.08.08] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The modern approach to cancer management has evolved into a multidisciplinary initiative focused not only on cancer specific and overall survival, but also patient quality of life and survivorship. Future fertility is often a major concern for young patients undergoing cancer therapy. Fertility preservation has emerged as a viable but significantly underutilized option. Patients and families should be aware of the varying effects of antineoplastic therapy on their future fertility to allow for an informed decision regarding their fertility preservation options. In this review we discuss the epidemiology, pathophysiology, and management of fertility in the setting of testicular cancer diagnosis and treatment.
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Affiliation(s)
- Neel V Parekh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Scott D Lundy
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Sarah C Vij
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
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16
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Baetas J, Rabaça A, Gonçalves A, Barros A, Sousa M, Sá R. Protective role of N-acetylcysteine (NAC) on human sperm exposed to etoposide. Basic Clin Androl 2019; 29:3. [PMID: 30774957 PMCID: PMC6366041 DOI: 10.1186/s12610-018-0082-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/28/2018] [Indexed: 01/02/2023] Open
Abstract
Background Although recent progress in cancer treatment has increased patient survival and improved quality of life, reproductive side effects are still for concern. One way to decrease gonadal impairment is to use cytoprotectors. In testicular cancer, etoposide is generally used in combination with other agents, but there are no in-vitro studies of sperm exposure to etoposide and cytoprotectors, namely N-acetylcysteine (NAC). Methods Twenty semen samples were individually divided into five groups: control, incubation with NAC alone, incubation with etoposide alone, sequential exposure of NAC followed by etoposide (pre-treatment) and sequential exposure of etoposide followed by NAC (post-treatment). Sperm characteristics, chromatin condensation (aniline blue), DNA fragmentation (TUNEL), oxidative stress (OxyDNA labelling) and glutathione quantification were used to evaluate the capabilities of NAC as a prophylactic (pre-treatment) or ameliorator (post-treatment) agent over the effects caused in sperm during in-vitro exposure to etoposide. Results No deleterious effects were observed on sperm motility or sperm membrane integrity. Results revealed that prophylactic use of NAC (pre-treatment) increased rates of immature sperm chromatin as compared to ameliorator use of NAC (post-treatment), and increased rates of sperm DNA fragmentation in relation to controls. Pre and post-treatment with NAC increased oxidative levels in comparison to controls, but also increased levels of cellular antioxidant glutathione. Conclusions The results indicate that NAC has the ability to counteract etoposide-induced toxicity rather than preventing the etoposide cytotoxic effects over sperm DNA, suggesting that the administration of NAC to cells formerly exposed to etoposide is preferable to its prophylactic use. As the results evidenced that NAC seems to be more efficient in attenuating sperm etoposide cytotoxic effects instead of being used as a chemoprophylactic agent, this reinforces the idea that there might be a new NAC mechanism over DNA.
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Affiliation(s)
- João Baetas
- 1Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.,2Faculty of Sciences, University of Porto, 4169-007 Porto, Portugal
| | - Ana Rabaça
- 1Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Ana Gonçalves
- Centre for Reproductive Genetics A. Barros (CGR), Av. do Bessa, 240, 1° Dto. Frente, 4100-012 Porto, Portugal
| | - Alberto Barros
- Centre for Reproductive Genetics A. Barros (CGR), Av. do Bessa, 240, 1° Dto. Frente, 4100-012 Porto, Portugal.,4Department of Genetics, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.,5Health Institute of Research and Innovation (IPATIMUP/i3S), University of Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
| | - Mário Sousa
- 1Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.,6Multidisciplinary Unit for Biomedical Research (UMIB), University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Rosália Sá
- 1Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.,6Multidisciplinary Unit for Biomedical Research (UMIB), University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
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Gurney JK. The puzzling incidence of testicular cancer in New Zealand: what can we learn? Andrology 2019; 7:394-401. [PMID: 30663250 DOI: 10.1111/andr.12584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/16/2018] [Accepted: 12/18/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Testicular germ cell tumour is the most common cancer to be diagnosed among young men. In New Zealand, we have observed some puzzling trends in the epidemiology of this disease. METHODS We have conducted a narrative review of available evidence regarding the puzzling epidemiology of testicular germ cell tumour in New Zealand and discussed the possible drivers of these trends. RESULTS AND DISCUSSION Whereas testicular cancer is most commonly a disease of White men, in New Zealand it is the indigenous Māori population that suffer by far the greatest rate of disease (age-adjusted relative risk: 1.80, 95% CI 1.58-2.05). Even more curiously, the rate of testicular germ cell tumour among Māori men aged 15-44 (28/100,000) is substantially greater than for Pacific Island men (9/100,000), a rare example of divergence between these two populations in terms of the incidence of any disease (cancer or otherwise). Our observations beg the following questions: first, why are rates of testicular germ cell tumour so much higher among Māori New Zealanders compared to the already high rates observed among European/Other New Zealanders? Second, why are rates of testicular germ cell tumour so completely divergent between Māori and Pacific New Zealanders, when these two groups typically move in parallel with respect to the incidence of given diseases? Finally, what might we learn about the factors that cause testicular germ cell tumour in general by answering these questions? CONCLUSION This review examines the possible drivers of our observed disparity, discusses their feasibility, and highlights new work that is underway to further understand these drivers.
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Affiliation(s)
- J K Gurney
- Cancer and Chronic Conditions (C3) Research Group, Department of Public Health, University of Otago, Wellington, New Zealand
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18
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Sperm cryopreservation for fertility preservation in male patients with cancer at a single-center in Japan. ACTA ACUST UNITED AC 2019. [DOI: 10.1097/grh.0000000000000034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Moody JA, Ahmed K, Yap T, Minhas S, Shabbir M. Fertility managment in testicular cancer: the need to establish a standardized and evidence-based patient-centric pathway. BJU Int 2018; 123:160-172. [DOI: 10.1111/bju.14455] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Jemma A. Moody
- GKT School of Medical Education; King's College London; London UK
- College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - Kamran Ahmed
- GKT School of Medical Education; King's College London; London UK
- Department of Urology; Guy's Hospital; London UK
| | - Tet Yap
- Department of Urology; Guy's Hospital; London UK
| | - Suks Minhas
- Imperial College Healthcare; NHS Trust; London UK
| | - Majid Shabbir
- GKT School of Medical Education; King's College London; London UK
- Department of Urology; Guy's Hospital; London UK
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20
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Hamano I, Hatakeyama S, Ohyama C. Fertility preservation of patients with testicular cancer. Reprod Med Biol 2017; 16:240-251. [PMID: 29259474 PMCID: PMC5715882 DOI: 10.1002/rmb2.12037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 04/10/2017] [Indexed: 11/23/2022] Open
Abstract
Background Testicular cancer (TC) is one of the most common malignancies in young men of reproductive age. Although TC is a curable malignancy with a high survival rate, its treatment requires various cytotoxic modalities and negatively impacts spermatogenesis; therefore, the fertility preservation of patients with TC has been studied. Methods In order to give an overview of fertility preservation in patients with TC, the literature was reviewed. Original and review articles were identified and examined on the basis of PubMed database searches. Results Chemotherapy and radiotherapy damage spermatogenesis and retroperitoneal lymph node dissection negatively impacts ejaculatory function. Testicular sperm extraction facilitates successful sperm retrieval in patients with TC with postchemotherapy azoospermia. Although preserved sperm is used with a very low frequency (8%), the conception rates in those who have used sperm are not inferior. Conclusion The number of studies is limited, and because numerous treatment factors affect fertility, outstanding questions remain about preserving the fertility of patients with TC. Further studies are necessary in order to determine the best means of preventing and treating infertility in patients with TC.
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Affiliation(s)
- Itsuto Hamano
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Shingo Hatakeyama
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Chikara Ohyama
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
- Department of Advanced Transplant and Regenerative MedicineHirosaki University Graduate School of MedicineHirosakiJapan
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21
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Armuand G, Skoog-Svanberg A, Bladh M, Sydsjö G. Reproductive Patterns Among Childhood and Adolescent Cancer Survivors in Sweden: A Population-Based Matched-Cohort Study. J Clin Oncol 2017; 35:1577-1583. [PMID: 28350518 DOI: 10.1200/jco.2016.71.0582] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To compare the probability of a first live birth, age at time of birth, and time between diagnosis/referent date and birth between childhood and adolescent cancer survivors and an age-matched comparison group. Materials and Methods A total of 1,206 survivors was included in the study, together with 2,412 age-matched individuals from the general population. A Cox proportional hazards model was used to investigate first live birth after diagnosis/referent date. Data were stratified by sex, age at diagnosis, and diagnostic era (ie, diagnosis before 1988 v in 1988 or later). Results Overall, the probability of having a first live birth (hazard ratio [HR]) was significantly lower; men had lower HRs than women (HR, 0.65 v 0.79). There were no significant differences in the probability of having a first live birth among women diagnosed during adolescence (HR, 0.89), but the HR was lower among women with childhood cancers (HR, 0.47). Among male survivors, the situation was the opposite; men diagnosed during adolescence had lower HRs than survivors of childhood cancer (HR, 0.56 v 0.70). Examination of the data from the two diagnostic eras (before 1988 and 1988 or later) shows that the HR increased among female survivors after 1988 (HR, 0.71 v 0.90) and decreased among male survivors (HR, 0.72 v 0.59). A shorter time had elapsed between diagnosis/referent date and the birth of a first child among both male and female survivors compared with controls. In addition, female survivors were younger at time of birth. Conclusion The study demonstrates reduced probability of having a first live birth among cancer survivors diagnosed during childhood or adolescence; men were particularly vulnerable.
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Affiliation(s)
| | | | - Marie Bladh
- All authors: Uppsala University, Uppsala, Sweden
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22
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Drobnis EZ, Nangia AK. Introduction to Medication Effects on Male Reproduction. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1034:1-4. [DOI: 10.1007/978-3-319-69535-8_1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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23
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Abstract
Sperm banking (SB) involves collecting and freezing sperm for potential future use. It is a simple, noninvasive way for male patients with cancer to preserve their ability to have biologic children. This article provides the information needed by nurses to effectively discuss SB with their patients.
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Gil T, Sideris S, Aoun F, van Velthoven R, Sirtaine N, Paesmans M, Ameye L, Awada A, Devriendt D, Peltier A. Testicular germ cell tumor: Short and long-term side effects of treatment among survivors. Mol Clin Oncol 2016; 5:258-264. [PMID: 27588190 DOI: 10.3892/mco.2016.960] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 12/11/2015] [Indexed: 02/07/2023] Open
Abstract
Long-term prognosis of germ cell tumor (GCT) types is excellent, however, treatment is associated with non-negligible complication rates and a negative impact on quality of life. The present study described treatment results in terms of survival, both short and long-term toxicity, and paternity rates in a cohort of patients treated at Jules Bordet Institute, University ULB of Brussels (Brussels, Belgium). The present study analyzed the data of a cohort of patients with GCT types. Pre-operative patient and tumor characteristics were described. Performance status, pulmonary function tests and renal clearance prior to chemotherapy were noted. Chemotherapeutic regimens and their associated toxicities were analyzed. The duration to event-free, cancer-specific and overall survivals were estimated using Kaplan-Meier curves. A total of 115 patients (median age, 31-years-old) were treated for a GCT at Jules Bordet Institute. At a median follow-up of 6-years, 11 (10%) patients had relapsed and 2 (2%) developed a second malignant neoplasm. At the final follow-up, 97 (89%) and 6 (5.5%) patients exhibited complete and partial remission, respectively. A total of 6% of patients exhibited a progressive disease. In terms of short-term toxicity, 11% of patients presented with febrile neutropenia. The 10-year overall survival rate and relapse-free survival rate were 93.4 and 89.8%, respectively. The paternity rate post-treatment was 27%. Testicular GCT survivors suffered from short- and long-term treatment-associated side effects on both a physical and psychological level. A long-term close follow-up is necessary in order to assist the patient with these treatment-induced complications.
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Affiliation(s)
- Thierry Gil
- Department of Oncology, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
| | - Spyridon Sideris
- Department of Oncology, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
| | - Fouad Aoun
- Department of Urology, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
| | - Roland van Velthoven
- Department of Urology, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
| | - Nicolas Sirtaine
- Department of Pathology, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
| | - Marianne Paesmans
- Department of Biostatistics, Data Center, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
| | - Lieveke Ameye
- Department of Biostatistics, Data Center, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
| | - Ahmad Awada
- Department of Oncology, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
| | - Daniel Devriendt
- Department of Oncology, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
| | - Alexandre Peltier
- Department of Urology, Jules Bordet Institute, University ULB of Brussels, B-1000 Brussels, Belgium
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Auger J, Sermondade N, Eustache F. Semen quality of 4480 young cancer and systemic disease patients: baseline data and clinical considerations. Basic Clin Androl 2016; 26:3. [PMID: 26893905 PMCID: PMC4758099 DOI: 10.1186/s12610-016-0031-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/05/2016] [Indexed: 11/25/2022] Open
Abstract
Background Except for testicular cancer and Hodgkin’s disease, baseline data on semen quality in case of cancers as well as systemic pathologies of the young adult are scarce or based on low sample size. Methods Semen quality in patients having testicular cancer (TGCT, n = 2315), Hodgkin’s disease (HD, n = 1175), non-Hodgkin’s lymphoma (NHL, n = 439), leukemia (L, n = 360), sarcoma (S, n = 208), brain tumour (BT, n = 40), Behcet’s disease (Behcet’s, n = 68) or multiple sclerosis (MS, n = 73) was studied and compared to that of 1448 fertile men candidates for sperm donation (CSD) and 208 partners of pregnant women (PPW). All samples were studied following the same methodology in a single laboratory. Post freezing and thawing semen characteristics were also studied. Results The percentage of normozoospermic men was only 37 % for L patients and lower than 60 % for TGCT, NHL, S and BT. The level of sperm production was differently decreased according to pathologies, the median total sperm count in TC and L patients being four times lower (p < 0.01 when compared to CSD and PPW). The lowest percentage of progressively motile spermatozoa was found for L and BT patients (both, p < 0.01 compared to CSD and PPW). The percentage of morphologically normal spermatozoa was also reduced in cancer patients, especially in BT patients. Progressive motility after thawing in patients was about half that observed among candidates for sperm donation. In almost half of the semen of patients with testicular cancer or leukemia, the total number of motile spermatozoa per straw was less than 0.5 × 106 compared to 4.3 × 106 in CSD. Conclusions The present data confirm on large series the deleterious impact of various cancers of the young adult on semen quality, establishing thus baseline data for future studies. Owing to the post-thaw quality of the frozen straws, future fertility projects for the majority of the patients studied (in case there is no post-treatment recovery of spermatogenesis) should necessitate an ICSI to provide the best chance of paternity whatever the fertility check-up in the female partner.
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Affiliation(s)
- Jacques Auger
- Service d'Histologie-Embryologie, Biologie de la Reproduction/CECOS, Hôpitaux Universitaires Paris Centre, Site Port-Royal, 53, Avenue de l'Observatoire, 75014 Paris, France ; INSERM U1016, Equipe "Génomique, Epigénétique et Physiologie de la Reproduction", Institut Cochin, Université Paris Descartes, Paris, France
| | - Nathalie Sermondade
- Service d'Histologie-Embryologie, Cytogénétique, Biologie de la Reproduction/CECOS, Hôpitaux Universitaires Paris Seine-Saint-Denis, Site Jean Verdier, 93143 Bondy, France
| | - Florence Eustache
- Service d'Histologie-Embryologie, Cytogénétique, Biologie de la Reproduction/CECOS, Hôpitaux Universitaires Paris Seine-Saint-Denis, Site Jean Verdier, 93143 Bondy, France ; INSERM U1016, Equipe "Génomique, Epigénétique et Physiologie de la Reproduction", Institut Cochin, Université Paris Descartes, Paris, France
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Abstract
BACKGROUND Loss of fertility is one of the many potential late effects of cancer treatment. For young men and women who have not yet started or completed building their families, this can be a source of considerable emotional distress. Advances in reproductive technology can enable many of these patients to preserve their fertility; however, discussions must be initiated early enough during treatment planning to enable them to take advantage of these options. OBJECTIVES The purpose of this article is to provide oncology nurses with information, strategies, and resources to discuss fertility with men and women starting cancer treatment. METHODS This article summarizes the literature on treatment-related fertility risks and fertility preservation options, and provides a systematic framework for nurses to integrate these discussions into practice. FINDINGS Oncology nurses can effectively collaborate with other members of the healthcare team to ensure that young men and women starting cancer treatment are informed of the potential risks to fertility from their planned treatment, understand options to preserve fertility before treatment, and, if interested, are referred to appropriate reproductive specialists.
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27
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Advances in cryopreservation of spermatogonial stem cells and restoration of male fertility. Microsc Res Tech 2015; 79:122-9. [DOI: 10.1002/jemt.22605] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 11/07/2015] [Indexed: 11/07/2022]
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Bindal A, Mahantshetty U, Tambe CM, Ghadi Y, Murthy V, Shrivastava SK. Testicular shielding in penile brachytherapy. J Contemp Brachytherapy 2015; 7:503-7. [PMID: 26816509 PMCID: PMC4716126 DOI: 10.5114/jcb.2015.56410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/26/2015] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Penile cancer, although rare, is one of the common genitourinary cancers in India affecting mostly aged uncircumcised males. For patients presenting with small superficial lesions < 3 cm restricted to glans, surgery, radical external radiation or brachytherapy may be offered, the latter being preferred as it allows organ and function preservation. In patients receiving brachytherapy, testicular morbidity is not commonly addressed. With an aim to minimize and document the doses to testis after adequate shielding during radical interstitial brachytherapy for penile cancers, we undertook this study in 2 patients undergoing brachytherapy and forms the basis of this report. MATERIAL AND METHODS Two patients with early stage penile cancer limited to the glans were treated with radical high-dose-rate (HDR) brachytherapy using interstitial implant. A total of 7-8 tubes were implanted in two planes, parallel to the penile shaft. A total dose of 44-48 Gy (55-60 Gy EQD2 doses with α/β = 10) was delivered in 11-12 fractions of 4 Gy each delivered twice daily. Lead sheets adding to 11 mm (4-5 half value layer) were interposed between the penile shaft and scrotum. The testicular dose was measured using thermoluminescent dosimeters. For each patient, dosimetry was done for 3 fractions and mean calculated. RESULTS The cumulative testicular dose to left and right testis was 31.68 cGy and 42.79 cGy for patient A, and 21.96 cGy and 23.28 cGy for patient B. For the same patients, the mean cumulative dose measured at the posterior aspect of penile shaft was 722.15 cGy and 807.72 cGy, amounting to 16.4% and 16.8% of the prescribed dose. Hence, the application of lead shield 11 mm thick reduced testicular dose from 722-808 cGy to 21.96-42.57 cGy, an "absolute reduction" of 95.99 ± 1.5%. CONCLUSIONS With the use of a simple lead shield as described, we were able to effectively reduce testicular dose from "spermicidal" range to "oligospermic" range with possible reversibility.
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Affiliation(s)
| | | | | | - Yogesh Ghadi
- Department of Medical Physics, Tata Memorial Hospital, Mumbai, India
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Abstract
Fertility preservation is the process by which either oocytes (eggs) or sperm undergo an intervention to preserve their use for future attempts at conception. Consideration of fertility preservation in the pediatric and adolescent population is important, as future childbearing is usually a central life goal. For postpubertal girls, both oocyte and embryo cryopreservation are standard of care and for postpubertal boys, sperm cryopreservation continues to be recommended. Although all the risks are unknown, it appears that fertility preservation in most cases does not worsen prognosis, allows for the birth of healthy children, and does not increase the chance of recurrence.
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Affiliation(s)
- Stephanie J Estes
- Donor Oocyte Program, Robotic Surgical Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Pennsylvania State University, College of Medicine, Hershey Medical Center, Mail Code H103, 500 University Drive, Hershey, PA 17033-0850, USA.
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30
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Petropanagos A, Campo-Engelstein L. Tough Talk: Discussing Fertility Preservation with Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2015; 4:96-9. [PMID: 26812662 DOI: 10.1089/jayao.2014.0047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Angel Petropanagos
- 1 Novel Tech Ethics, Faculty of Medicine, Dalhousie University , Halifax, Canada
| | - Lisa Campo-Engelstein
- 2 Alden March Bioethics Institute and Department of Obstetrics and Gynecology, Albany Medical College , Albany, New York
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31
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Harrison DJ, Schwartz C. Survivorship. J Surg Oncol 2014; 111:648-55. [PMID: 25557722 DOI: 10.1002/jso.23844] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 10/13/2014] [Indexed: 01/04/2023]
Abstract
Significant therapeutic advances for soft tissue sarcomas allow increasing numbers of patients--adult and pediatric--to achieve long term survival. However, the harsh cytotoxic therapies are responsible for adverse physical and psychosocial effects that require long-term follow-up care, specific to survivorship issues. In the adult and pediatric patient population, guidelines for care developed by experts in comprehensive survivorship clinics are evolving to assist the practitioner while on-line supports bring information directly to the survivors.
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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. [PMID: 24369141 PMCID: PMC3901866 DOI: 10.4103/1008-682x.122194] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Testicular cancer (TC) is the most curable type of cancer, with a survival rate of more than 95%. Oncologists are faced with the challenge that gonadotoxic cancer treatments can compromise future fertility, either temporarily or permanently. Our aim was to investigate the long-term effects of TC treatments on male fertility and on the offspring of patients who had received these treatments. Between January 1996 and December 2010, 125 eligible patients, ranging from 18 to 54 years (median age 36.3 ± 15.7), with unilateral TC underwent surgery, chemotherapy or radiotherapy at our center. Some of these patients had their semen samples cryopreserved in the Shanghai Human Sperm Bank. The clinical data were evaluated, and questionnaire and telephone follow-up surveys were given to all patients. The data were analyzed to determine the patients’ fertility status pre- and posttreatment. Of the 125 eligible patients, 93.6% (117/125) were accessible and were evaluated. Among 81 men who were married before diagnosis, 21 had conceived successfully before diagnosis and six reported azoospermia. Posttreatment conception was attempted by 73 men; of these, 16 conceived naturally and 19 conceived by artificial reproductive techniques, resulting in 37 healthy babies with no congenital malformations. Of the patients who had not conceived before treatment, 21.9% (21/96) banked their sperm and 23.8% of these patients (5/21) subsequently used the banked sperm. Retroperitoneal lymph node dissection, chemotherapy and radiotherapy were the most highly correlated with lack of conception post-TC treatment. Sperm banking should be recommended to TC patients with the desire for biological conception. There is no evidence to suggest that TC treatments are associated with birth defects or childhood malignancies.
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Affiliation(s)
| | | | | | | | - Zheng Li
- Department of Urology, Shanghai Human Sperm Bank, Shanghai Institute of Andrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
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Goldfarb S, Mulhall J, Nelson C, Kelvin J, Dickler M, Carter J. Sexual and reproductive health in cancer survivors. Semin Oncol 2014; 40:726-44. [PMID: 24331193 DOI: 10.1053/j.seminoncol.2013.09.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
As patients live longer after cancer diagnosis and treatment, attention to symptoms and quality of life (QoL) are of increasing importance both during treatment and throughout survivorship. Two complications of multi-modal cancer treatment that can profoundly affect both men and women are sexual dysfunction and infertility. Survivors at highest risk for treatment-related sexual dysfunction are those with tumors that involve the sexual or pelvic organs and those whose treatment affects the hormonal systems mediating sexual function. Sexual dysfunction may not abate without appropriate intervention. Therefore, early identification and treatment strategies are essential. Likewise, multiple factors contribute to the risk of infertility from cancer treatment and many cancer patients of reproductive age would prefer to maintain their fertility, if possible. Fortunately, advances in reproductive technology have created options for young newly diagnosed patients to preserve their ability to have a biologic child. This paper will focus on the sexual and reproductive problems encountered by cancer survivors and discuss some treatment options.
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Affiliation(s)
- Shari Goldfarb
- Departments of Medicine and Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY.; Department of Medicine, Weill Cornell Medical College, New York, NY..
| | - John Mulhall
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Joanne Kelvin
- Office of Physician-In-Chief Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Maura Dickler
- Department of Medicine, Weill Cornell Medical College, New York, NY.; Department of Medicine Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jeanne Carter
- Departments of Surgery and Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
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Ronn R, Holzer HEG. Oncofertility in Canada: gonadal protection and fertility-sparing strategies. ACTA ACUST UNITED AC 2013; 20:e602-7. [PMID: 24311962 DOI: 10.3747/co.20.1359] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cancer can be a devastating diagnosis. In particular, malignancy and its indicated treatments have profoundly negative effects on the fertility of young cancer patients. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer therapies and to facilitate fertility preservation. In Canada, fertility issues are often inadequately addressed despite the availability of resources. The goal of this four-part series is to facilitate systemic improvements in fertility preservation for adolescent and young adult Canadians with a new diagnosis of cancer. METHODS Here, we review the fertility preservation measures currently available. Medical and surgical strategies are both outlined. RESULTS Fertility-preserving strategies and gonadal protection have demonstrated variable success in a number of approaches. The value of hormone suppression is still in question for women. Progestins for endometrial cancer and alternative chemotherapies are other medical approaches. Gonadal shielding and protective surgical approaches have also been attempted. CONCLUSIONS The techniques discussed here may be selectively considered and integrated into patient care in an attempt to preserve future fertility before initiating cancer treatment.
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Affiliation(s)
- R Ronn
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON
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Uygur R, Aktas C, Tulubas F, Uygur E, Kanter M, Erboga M, Caglar V, Topcu B, Ozen OA. Protective effects of fish omega-3 fatty acids on doxorubicin-induced testicular apoptosis and oxidative damage in rats. Andrologia 2013; 46:917-26. [DOI: 10.1111/and.12173] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- R. Uygur
- Faculty of Medicine; Department of Anatomy; Namik Kemal University; Tekirdag Turkey
| | - C. Aktas
- Faculty of Medicine; Department of Histology and Embryology; Namik Kemal University; Tekirdag Turkey
| | - F. Tulubas
- Faculty of Medicine; Department of Biochemistry; Namik Kemal University; Tekirdag Turkey
| | - E. Uygur
- Vocational School of Health Services; Namik Kemal University; Tekirdag Turkey
| | - M. Kanter
- Faculty of Medicine; Department of Histology and Embryology; Istanbul Medeniyet University; Istanbul Turkey
| | - M. Erboga
- Faculty of Medicine; Department of Histology and Embryology; Namik Kemal University; Tekirdag Turkey
| | - V. Caglar
- Faculty of Medicine; Department of Anatomy; Namik Kemal University; Tekirdag Turkey
| | - B. Topcu
- Faculty of Medicine; Department of Biostatistics; Namik Kemal University; Tekirdag Turkey
| | - O. A. Ozen
- Faculty of Medicine; Department of Anatomy; Namik Kemal University; Tekirdag Turkey
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Ronn R, Holzer HEG. Oncofertility in Canada: the impact of cancer on fertility. ACTA ACUST UNITED AC 2013; 20:e338-44. [PMID: 23904772 DOI: 10.3747/co.20.1358] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cancer can be a devastating diagnosis. In particular, malignancy and its indicated treatments have profoundly negative effects on the fertility of young cancer patients. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer therapies and to facilitate fertility preservation. In Canada, these fertility issues are often inadequately addressed despite the availability of resources. The goal of this four-part series is to facilitate systemic improvements in fertility preservation for adolescent and young adult Canadians with a new diagnosis of cancer. METHODS In this article, we review the gonadotoxic effects of cancer treatment on young men and women of reproductive age. RESULTS The detrimental effects of cancer on fertility can be severe and may vary depending on the chemotherapy, radiotherapy, or surgical treatments involved. CONCLUSIONS Fertility preservation should be addressed in an effort to mitigate the gonadal damage that may come with cancer therapy.
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Affiliation(s)
- R Ronn
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON
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Kelvin JF, Kroon L, Ogle SK. Fertility Preservation for Patients With Cancer. Clin J Oncol Nurs 2012; 16:205-10. [DOI: 10.1188/12.cjon.205-210] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Banks K, Tuazon E, Berhane K, Koh CJ, De Filippo RE, Chang A, Kim SS, Daneshmand S, Davis-Dao C, Lewinger JP, Bernstein L, Cortessis VK. Cryptorchidism and testicular germ cell tumors: comprehensive meta-analysis reveals that association between these conditions diminished over time and is modified by clinical characteristics. Front Endocrinol (Lausanne) 2012; 3:182. [PMID: 23423470 PMCID: PMC3574983 DOI: 10.3389/fendo.2012.00182] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 12/20/2012] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Risk of testicular germ cell tumors (TGCT) is consistently associated with a history of cryptorchidism (CO) in epidemiologic studies. Factors modifying the association may provide insights regarding etiology of TGCT and suggest a basis for individualized care of CO. To identify modifiers of the CO-TGCT association, we conducted a comprehensive, quantitative evaluation of epidemiologic data. MATERIALS AND METHODS Human studies cited in PubMed or ISI Web of Science indices through December 2011 and selected unpublished epidemiologic data were reviewed to identify 35 articles and one unpublished dataset with high-quality data on the CO-TGCT association. Association data were extracted as point and 95% confidence interval estimates of odds ratio (OR) or standardized incidence ratio (SIR), or as tabulated data. Values were recorded for each study population, and for subgroups defined by features of study design, CO and TGCT. Extracted data were used to estimate summary risk ratios (sRR) and evaluate heterogeneity of the CO-TGCT association between subgroups. RESULTS The overall meta-analysis showed that history of CO is associated with four-fold increased TGCT risk [RR = 4.1(95% CI = 3.6-4.7)]. Subgroup analyses identified five determinants of stronger association: bilateral CO, unilateral CO ipsilateral to TGCT, delayed CO treatment, TGCT diagnosed before 1970, and seminoma histology. CONCLUSIONS Modifying factors may provide insight into TGCT etiology and suggest improved approaches to managing CO. Based on available data, CO patients and their parents or caregivers should be made aware of elevated TGCT risk following orchidopexy, regardless of age at repair, unilateral vs. bilateral non-descent, or position of undescended testes.
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Affiliation(s)
- Kimberly Banks
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- City of Hope National Medical CenterDuarte, CA, USA
- St. Joseph HospitalOrange, CA, USA
| | - Ellenie Tuazon
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Kiros Berhane
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Chester J. Koh
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Roger E. De Filippo
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Andy Chang
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Steve S. Kim
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Siamak Daneshmand
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Carol Davis-Dao
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Juan P. Lewinger
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
| | - Leslie Bernstein
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- City of Hope National Medical CenterDuarte, CA, USA
| | - Victoria K. Cortessis
- Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA
- *Correspondence: Victoria K. Cortessis, Department of Preventive Medicine, University of Southern California, 1441 Eastlake Avenue, MC-9175, Los Angeles, CA 90089-9175, USA. e-mail:
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Bizet P, Saias-Magnan J, Jouve E, Grillo JM, Karsenty G, Metzler-Guillemain C, Perrin J. Sperm cryopreservation before cancer treatment: a 15-year monocentric experience. Reprod Biomed Online 2011; 24:321-30. [PMID: 22285245 DOI: 10.1016/j.rbmo.2011.11.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 11/16/2011] [Accepted: 11/17/2011] [Indexed: 11/19/2022]
Abstract
Sperm banking is an important procedure to preserve fertility before cancer therapy. The aim of this study was to comprehensively analyse cryopreservation activity retrospectively for 1080 patients referred to the sperm bank for sperm cryopreservation before cancer treatment. This study included 1007 patients diagnosed with testicular cancer (TC) (41.7%), lymphoma (26%), other haematological cancers (9.4%) or other types of cancer (22.8%); of these, 29 patients did not produce any semen sample and cryopreservation was impossible for 67 patients. Semen characteristics before treatment were within normal ranges, except moderate asthenospermia. Sperm concentration was significantly lower in TC than in non-TC. Straws from 57 patients (6.3%) were used in assisted reproductive technologies, which led to a 46.8% cumulative birth rate. Straws were destroyed for 170 patients (18.7%) and 140 patients performed semen analyses after cancer therapy. After an average delay of 22.5 months after the end of therapy, 43 patients (30.7%) exhibited azoospermia. This study of a large population of cancer patients revealed a high level of successful sperm storage. Utilization of cryopreserved spermatozoa led to good chances of fatherhood. Nevertheless, sperm banks should be aware of the low rates of straw use and straw destruction by cancer patients.
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Affiliation(s)
- P Bizet
- Aix-Marseille Université, AP-HM La Conception, CECOS-Laboratoire de Biologie de la Reproduction, Pôle de Gynécologie-Obstétrique et Reproduction, 147, Boulevard Baille, 13005 Marseille, France
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Ovarian response to stimulation for fertility preservation in women with malignant disease: a systematic review and meta-analysis. Fertil Steril 2011; 97:125-33. [PMID: 22078784 DOI: 10.1016/j.fertnstert.2011.10.014] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 09/28/2011] [Accepted: 10/12/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the current available data regarding ovarian performance of patients diagnosed with malignant disease undergoing controlled ovarian hyperstimulation (COH) for fertility preservation, before radio/chemotherapy, compared with age-matched, healthy patients undergoing COH for in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI). DESIGN Meta-analysis of the data available from a systematic review of the literature. SETTING Academic centers of infertility and IVF. PATIENT(S) Patients with malignant disease, before radio/chemotherapy, undergoing COH for fertility preservation within comparative studies with healthy, age-matched controls. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Peak estradiol levels on day of human chorionic gonadotropin administration, number of oocytes retrieved, fertilization rate, incidence of low ovarian response, and cycle cancellation. RESULT(S) Only seven retrospective, case-controlled studies were found to match our objective. Overall, the results of the meta-analysis indicate that the number of retrieved oocytes rate was statistically significantly lower compared with age-matched healthy IVF patients. The incidence of poor ovarian performance and risk of cycle cancellation as well as the calculated number of two pronuclei zygotes achieved among patients with cancer were comparable with their age-matched controls. CONCLUSION(S) Women with malignant disease should expect a lower number of oocytes retrieved after COH for fertility preservation, compared with healthy, age-matched patients. Presently, there is paucity of evidence to assess the effect of a specific malignant disease on ovarian response to COH before IVF for fertility preservation. Multicentric studies should be conducted to resolve these important issues.
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Abstract
The current concepts, recommendations, and principles of sperm banking as it pertains to the comprehensive care of young men of reproductive age with cancer are reviewed. Obstacles to sperm banking are addressed as well as future directions for fertility-preserving technologies. All cancer therapies-chemotherapy, radiation, and surgery-are potential threats to a man's reproductive potential. In addition, cancer itself can impair spermatogenesis. Thus, sperm cryopreservation prior to initiating life-saving cancer treatment offers men and their families the best chance to father biologically related children and should be offered to all men with cancer before treatment. Better patient and provider education, as well as deliberate, coordinated strategies at comprehensive cancer care centers are necessary to make fertility preservation for male cancer patients a priority during pretreatment planning.
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Affiliation(s)
- Daniel H Williams
- Department of Urology, University of Wisconsin-Madison,600 Highland Avenue,Madison, WI 53792, USA
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Freour T, Mirallie S, Jean M, Barriere P. Sperm banking and assisted reproductive outcome in men with cancer: a 10 years’ experience. Int J Clin Oncol 2011; 17:598-603. [DOI: 10.1007/s10147-011-0330-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 09/19/2011] [Indexed: 12/01/2022]
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Favareto APA, Fernandez CDB, da Silva DAF, Anselmo-Franci JA, Kempinas WDG. Persistent Impairment of Testicular Histology and Sperm Motility in Adult Rats Treated with Cisplatin at Peri-Puberty. Basic Clin Pharmacol Toxicol 2011; 109:85-96. [DOI: 10.1111/j.1742-7843.2011.00688.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Moria A, Das M, Shehata F, Holzer H, Son WY, Tulandi T. Ovarian reserve and oocyte maturity in women with malignancy undergoing in vitro maturation treatment. Fertil Steril 2011; 95:1621-3. [DOI: 10.1016/j.fertnstert.2010.12.041] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Revised: 12/18/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
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Targeted disruption of Ing2 results in defective spermatogenesis and development of soft-tissue sarcomas. PLoS One 2010; 5:e15541. [PMID: 21124965 PMCID: PMC2988811 DOI: 10.1371/journal.pone.0015541] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 10/06/2010] [Indexed: 12/23/2022] Open
Abstract
ING2 (inhibitor of growth family, member 2) is a member of the plant homeodomain (PHD)-containing ING family of putative tumor suppressors. As part of mSin3A-HDAC corepressor complexes, ING2 binds to tri-methylated lysine 4 of histone H3 (H3K4me3) to regulate chromatin modification and gene expression. ING2 also functionally interacts with the tumor suppressor protein p53 to regulate cellular senescence, apoptosis and DNA damage response in vitro, and is thus expected to modulate carcinogenesis and aging. Here we investigate the developmental and physiological functions of Ing2 through targeted germline disruption. Consistent with its abundant expression in mouse and human testes, male mice deficient for Ing2 showed abnormal spermatogenesis and were infertile. Numbers of mature sperm and sperm motility were significantly reduced in Ing2−/− mice (∼2% of wild type, P<0.0001 and ∼10% of wild type, P<0.0001, respectively). Their testes showed degeneration of seminiferous tubules, meiotic arrest before pachytene stage with incomplete meiotic recombination, induction of p53, and enhanced apoptosis. This phenotype was only partially abrogated by concomitant loss of p53 in the germline. The arrested spermatocytes in Ing2−/− testes were characterized by lack of specific HDAC1 accumulation and deregulated chromatin acetylation. The role of Ing2 in germ cell maturation may extend to human ING2 as well. Using publicly available gene expression datasets, low expression of ING2 was found in teratozoospermic sperm (>3-fold reduction) and in testes from patients with defective spermatogenesis (>7-fold reduction in Sertoli-cell only Syndrome). This study establishes ING2 as a novel regulator of spermatogenesis functioning through both p53- and chromatin-mediated mechanisms, suggests that an HDAC1/ING2/H3K4me3-regulated, stage-specific coordination of chromatin modifications is essential to normal spermatogenesis, and provides an animal model to study idiopathic and iatrogenic infertility in men. In addition, a bona fide tumor suppressive role of Ing2 is demonstrated by increased incidence of soft-tissue sarcomas in Ing2−/− mice.
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Oncologists’ knowledge and practice towards sperm cryopreservation in Arabic communities. J Cancer Surviv 2010; 4:279-83. [DOI: 10.1007/s11764-010-0140-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Accepted: 06/29/2010] [Indexed: 10/19/2022]
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Delouya G, Baazeem A, Boman JM, Violette P, Saad F, Zini A. Identification of Spermatozoa in Archived Testicular Cancer Specimens: Implications for Bench Side Sperm Retrieval at Orchiectomy. Urology 2010; 75:1436-40. [DOI: 10.1016/j.urology.2009.10.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Revised: 10/28/2009] [Accepted: 10/30/2009] [Indexed: 11/25/2022]
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Noyes N, Labella PA, Grifo J, Knopman JM. Oocyte cryopreservation: a feasible fertility preservation option for reproductive age cancer survivors. J Assist Reprod Genet 2010; 27:495-9. [PMID: 20480389 DOI: 10.1007/s10815-010-9434-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 05/05/2010] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To compare oocyte cryopreservation cycles performed in cancer patients to those of infertile women. METHODS Cancer patients referred for fertility preservation underwent counseling in compliance with the ASRM; those electing oocyte cryopreservation were included. Ovarian stimulation was achieved with injectable gonadotropins and freezing was performed using slow-cooling and vitrification methods. RESULTS Fifty cancer patients (mean age 31 y) underwent oocyte cryopreservation; adequate ovarian stimulation was achieved in 10 ± 0.3 days. The outcome from these cycles included a mean peak estradiol of 2,376 pg/ml and an average of 19 oocytes retrieved (15 mature oocytes were cryopreserved/cycle). All patients tolerated ovarian hyperstimulation. There were no significant differences noted between cryopreservation cycles performed in cancer patients and in women without malignancy. CONCLUSIONS Oocyte cryopreservation appears to be a feasible fertility preservation method for reproductive-age women diagnosed with cancer. This modality is not only effective but also, providing a multidiscipline effort, can be completed in timely fashion.
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Affiliation(s)
- Nicole Noyes
- NYU Fertility Center, NYU School of Medicine, New York, NY 10016, USA.
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Surviving childhood and reproductive-age malignancy: effects on fertility and future parenthood. Lancet Oncol 2010; 11:490-8. [PMID: 20153978 DOI: 10.1016/s1470-2045(09)70317-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Annually, more than 50,000 cancer diagnoses are made in the USA in patients under the age of 35 years. Despite this staggering statistic, medical advancements have substantially improved survival rates. Thus, for both male and female patients with cancer, quality-of-life issues, such as fertility preservation and parenthood, have become an essential component of treatment. Unfortunately, many of the treatments to eradicate malignant processes can also compromise reproductive function. In these cases, fertility preservation should be discussed and initiated with early treatment planning, to allow the best chance for future parenthood, when appropriate. The effects of cancer and cancer treatments on fertility and future parenthood, including health risks for patients, their gametes, and offspring are discussed.
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