Potential transmission of the cytogenetic effects of cisplatin in the male germline cells of Swiss mice

Male infertility and urological tumors: Pathogenesis and therapeutical implications

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.

Assessing Optimal Cell Counts in Sperm Shape Abnormality Assays in Rodents

Rodents have been the preferred models for the evaluation of the toxicity of pollutants and drugs and their genotoxic effects, including sperm shape abnormalities. The scientific literature is dominated by studies conducted with model animals in laboratory conditions, but a generally accepted and standardized protocol addressing the optimal number of sperm cells to count is still lacking. In this study, we reviewed the literature regarding the number of counted sperm cells in such assessments, published from 1969 to 2023. To infer the number of counts providing the best cost/benefit regarding the robustness of the assay results, a new dataset involving the analysis of two populations of wild rodents was produced. We evaluated the frequency of sperm shape abnormalities in a total of 50 wild brown rats (Rattus norvegicus) captured in two port cities, aiming to detect the impact of differential sperm cell counts in the obtained results. During necropsy, the fresh epididymis tail of adult male rats was excised, and sperm cells were fixated in slides. For each animal, a total of 300, 500, 1000, and 2000 cells were sequentially counted, and head abnormalities were registered. Counting 300 sperm cells failed to detect significant differences between groups and 500 counts resulted in marginally significant differences. Only when 1000 or 2000 sperm cells were counted, significant differences emerged between groups. We propose that studies addressing sperm shape abnormalities should standardize counts to an optimal value of 1000 cells per animal, warranting robust statistical results while providing the best compromise concerning labor time.

Recovery of Spermatogenesis Following Cancer Treatment with Cytotoxic Chemotherapy and Radiotherapy

The survival rates of boys and men with cancer have increased due to advances in cancer treatments; however, maintenance of quality of life, including fertility preservation, remains a major issue. Fertile male patients who receive radiation and/or chemotherapy face temporary, long-term, or permanent gonadal damage, particularly with exposure to alkylating agents and whole-body irradiation, which sometimes induce critical germ cell damage. These cytotoxic treatments have a significant impact on a patient's ability to have their own biological offspring, which is of particular concern to cancer patients of reproductive age. Therefore, various strategies are needed in order to preserve male fertility. Sperm cryopreservation is an effective method for preserving spermatozoa. Advances have also been achieved in pre-pubertal germ cell storage and research to generate differentiated male germ cells from various types of stem cells, including embryonic stem cells, induced pluripotent stem cells, and spermatogonial stem cells. These approaches offer hope to many patients in whom germ cell loss is associated with sterility, but are still experimental and preliminary. This review examines the current understanding of the effects of chemotherapy and radiation on male fertility.

Immunosuppressants and Male Reproduction

Prolonged use of immunosuppressant medications is occasionally seen in infertile men with chronic inflammatory conditions; autoimmune disorders; or an organ or hematopoietic stem cell transplant. Chronic inflammation impacts negatively on male reproductive endpoints, so immunosuppressant therapy can produce improvements. Corticosteroids have been used to treat antisperm antibodies and even as an empirical treatment for male infertility in general. Trials of these methods have provided mixed results on semen quality and fertility, with improvement, no change and negative effects reported by different investigators. In a substantial number of observational studies, patients on long-term therapy with prednisone for chronic inflammatory disease, testosterone levels were lower compared to untreated controls, though randomized controlled trials have not been conducted. Similarly decreases in testosterone have been reported in men receiving corticosteroids to minimize transplant rejection; however, most were treated with multiple immunosuppressive medications that may have contributed to this effect. A large number of trials of healthy men treated with corticosteroids have shown some disruption in reproductive hormone levels, but other studies reported no effect. Studies in monkeys, rats (at human equivalent dose), cattle, sheep, and horses have shown endocrine disruption, including low testosterone with dexamethasone treatment. Of the cytostatic immunosuppressives, which have high potential for cellular damage, cyclophosphamide has received the most attention, sometimes lowering sperm counts significantly. Methotrexate may decrease sperm numbers in humans and has significant negative impacts in rodents. Other chemotherapeutic drugs used as immunosuppressants are likely to impact negatively on male fertility endpoints, but few data have been collected. The TNF-α Inhibitors have also received little experimental attention. There is some evidence that the immunophilin modulators: cyclosporine, sirolimus, and everolimus cause endocrine disruption and semen quality impairment. As we review in this chapter, results in experimental species are concerning, and well-designed studies are lacking for the effects of these medications on reproductive endpoints in men.

Current practices in fertility preservation in male cancer patients

The incidence of a cancer diagnosis in children and young adolescents is increasing. With better treatments, the number of young cancer survivors living through reproductive age is increasing. Fertility preservation of these men and women has become essential and needs to be discussed prior to the start of cancer treatment. Here we review the current guidelines for male oncofertility patients and highlight some of the important gonadotoxic effects of chemotherapy, radiotherapy and surgery. Options for fertility preservation are also discussed along with resources that should be made available to all patients.

Vitamin C Modulation of Cisplatin-Induced Cytogenotoxicity in Bone Marrow, Spermatogonia and its Transmission in the Male Germline of Swiss Mice

Relative modulatory effects of three different doses of vitamin C (VC), 10, 20 and 40 mg/kg, on cytogenotoxicity induced by cisplatin (CP) 5 mg/kg were assessed from the comparison of chromosomal aberrations (CAs) and mitotic index in bone marrow cells, micronucleus test (MNT) in polychromatic erythrocytes from the somatic cell line and spermatogonial chromosome aberrations (SCAs), primary spermatocytic chromosome analysis and sperm morphology assay from the male germline of VC-pretreated and CP-alone treated mice. Each pretreatment dose of VC protected bone marrow cells from the CP-induced cytogenotoxicity by decreasing the aberrant metaphases, CAs and MN significantly, particularly the lower doses. The protection was inversely proportional to the pretreated dose of VC i.e., the higher the dose of VC the less protection was provided. The lower doses of VC also protected the spermatogonial cells by significantly decreasing the CP-induced aberrant metaphases and SCAs, whereas the highest dose potentiated such effects by increasing them significantly. Besides, transmission of CP-induced cytogenotoxicity in the male germline was enhanced significantly in all VC pretreated mice, resulting in an increase in the frequency of aberrant prima ry spermatocytes and abnormal sperm. Since the spermatogonial cells with gross effects were eliminated/died, the tolerable effects stabilized in some of them were transmitted through the male germline with the consequent increase in the manifestation of aberrant primary spermatocytes and abnormal sperm. However, VC failed to decrease in the transmission of such effects. Thus, the protective action of VC was dose dependent and tissue specific. Moreover, the time of VC treatment i.e., its pre- or post-treatment to the exposure of cells to cytogenotoxic substances is important in providing protection from or potentiation of the cytogenotoxic effects.

Gonadal damage and options for fertility preservation in female and male cancer survivors

It is estimated that in 2010, 1 in every 250 adults will be a childhood cancer survivor. Today, oncological surgery, radiotherapy and chemotherapy achieve relatively high rates of remission and long-term survival, yet are often detrimental to fertility. Quality of life is increasingly important to long-term survivors of cancer, and one of the major quality-of-life issues is the ability to produce and raise normal children. Developments in the near future in the emerging field of fertility preservation in cancer survivors promise to be very exciting. This article reviews the published literature, discusses the effects of cancer treatment on fertility and presents the options available today thanks to advances in assisted-reproduction technology for maintaining fertility in male and female patients undergoing this type of treatment. The various diagnostic methods of assessing the fertility potential and the efficacy of in vitro fertilization (IVF) after cancer treatment are also presented.

Vitamin E protection from/potentiation of the cytogenetic toxicity of cisplatin in Swiss mice

Possible protection from or potentiation of the cytogenetic toxic effects of cisplatin (CP) 5 mg/kg b.w. in mouse bone marrow, spermatogonia by three different doses of alpha-tocopheryl acetate (vitamin E) 100, 200 and 300 mg/kg, and the transmission of such effects in the male germline, were assessed. CP-induced chromosomal aberrations (CAs) in bone marrow were decreased in vitamin E pretreated mice, but significantly (P < or = 0.05) only with vitamin E 300 mg/kg. The percentages of dividing cells in bone marrow were increased in vitamin E-pretreated groups of mice, but not significantly. However, the frequency of CP-induced micronuclei (MN) in polychromatic erythrocytes (PCEs) declined significantly (P < or = 0.01) in all the vitamin E-pretreated groups of mice. In spermatogonia the CP-induced CAs were also decreased significantly by vitamin E 200 mg/kg (P < or = 0.01), and 100 and 300 mg/kg (P < or = 0.05). However, transmission of CP-induced cytogenetic toxic effects from spermatogonia to spermatocyte, resulting in the formation of aberrant primary spermatocytes, was enhanced significantly in the mice pretreated with vitamin E 100 mg/kg (P < or = 0.05) and 200 mg/kg (P < or = 0.01). But the enhancement in the transmission of such effects was not significant in the mice pretreated with vitamin E 300 mg/kg. Besides, there was no significant change in vitamin E-pretreated groups of mice in the transmission of cytogenetic toxicity of CP from spermatogonia to sperm with the manifestation of abnormal sperm morphology. Thus, vitamin E protected bone marrow and spermatogonia from the cytogenetic toxic effects of CP, particularly efficiently at the highest tested dose (300 mg/kg), but it failed to protect from the transmission of such effects in the male germline of mouse and rather potentiated them to some extent. Treatment with vitamin E, an antioxidant, might be capable of protecting noncancerous cells from the oxidative damage caused by cisplatin but it might also reduce the effects of cisplatin on cancerous cells. Thus, the benefits of antioxidant treatment during cancer chemotherapy is yet to be demonstrated clearly.

Potential transmission of the cytogenetic toxic effects of methotrexate in the male germline cells of Swiss mice

On testing the cytogenetic toxic effects of methotrexate, a widely prescribed antineoplastic drug, in the male germline cells of Swiss mice, it was found highly clastogenic to the spermatogonial cells at 24-h post-treatment after a single intraperitoneal exposure. The occurrence of significant percentages of aberrant primary spermatocytes with atypical bivalents at week 4 post-treatment and a little higher percentages of sperm with abnormal morphology at week 8 post-treatment indicated the potential transmission of the induced cytogenetic toxic effects of methotrexate from spermatogonia to sperm in the male germline cells of Swiss mice.