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Citations Publications citing this paper. The protective effect of regucalcin against radiation-induced testicular damage Ana Manuela dos Santos Silva. Preserving fertility in young patients with lymphoma: an overview Bansari Patel , Brooke V. Joanne Frankel Kelvin. The protective effect of regucalcin against radiation-induced damage in testicular cells.
Sexual and reproductive health in cancer survivors. Shari B. Goldfarb , John P. References Publications referenced by this paper.
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A nationwide survey of oncologists regarding treatment-related infertility and fertility preservation in female cancer patients Eric J. Marilyn A Crawshaw , Patricia Sloper. An experimental protocol for fertility preservation in prepubertal boys recently diagnosed with cancer: a report of acceptability and safety.
Jill P. Male infertility is an inability to produce healthy sperm or to ejaculate sperm. Although sperm production usually recovers after cancer treatment, but discuss the risks of infertility with your healthcare provider before cancer treatment begins. Sperm can be preserved and frozen for future use.
Preserving Fertility in Men with Cancer
However, if you have already started treatment, chemotherapy or radiation can cause genetic damage to sperm cells. Set up an appointment with a member of your health care team to discuss concerns or questions you may have. Ask for a referral to a fertility clinic or specialist. Learning about infertility can cause stress. You may worry about the impact on your relationship or feel a loss of self-esteem. Talk with your health care provider if you think that the topic of infertility may be having an impact on your emotional well-being and consider whether a support group or some counseling could be helpful.
Infertility is most likely to happen before cancer treatment and just after treatment is finished. An initial analysis may show infertility, but the results could change over the next month or even years. For those who will recover sperm production, semen analysis will usually improve within one to three years after finishing cancer treatment.
However, some men improve many years later. Men should use effective means of birth control even if there is possibility of infertility. Testicular cancer: Fertility may be poor during the two years before testicular cancer is discovered.
Although only one to three percent of men with testicular cancer get cancer in both testicles, the cancer-free testicle may not function normally. On the other hand, men treated for testicular cancer often end up with improved semen quality within several years. Newly-diagnosed Hodgkin's disease, lymphoma or leukemia: Recent surgery, fever or physical stress experienced by survivors may affect the quality of semen. Cancer treatment, not cancer itself, is often what damages fertility. Here are some common treatments and their possible effects on fertility.
A man is at higher risk for infertility if he gets two or more alkylating chemotherapy drugs, has higher doses of chemotherapy for example before a stem cell or bone marrow transplant , or has a combination of chemotherapy and pelvic or whole body radiation.
A semen analysis tests a man's fertility. A sample is collected very soon after ejaculation and examined under a microscope. The analysis usually includes at least three scores that define semen quality:. How it works: Before beginning chemotherapy or radiation, a man produces a semen sample at a medical laboratory or sperm bank or from home. Masturbation is the preferred method, since even using a condom during intercourse could leave the semen contaminated with bacteria. Samples produced at home need to be kept at body temperature and delivered to the lab within an hour.
Fertility Preservation in Adult Male Cancer Patients
Some sperm banks provide kits a man can use at home, mixing a preserving chemical with his semen and using overnight mail to the lab. A semen analysis is done.
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As long as the sample contains some live sperm cells, it can be frozen and stored for future use in infertility treatment. Once frozen, samples can be kept for at least 20 to 30 years possibly longer without further damage. How it works: If a boy is too young to produce sperm cells but will have a high risk of infertility after his cancer treatment, an experimental option is to put him under anesthesia for an outpatient surgery, remove several areas of tissue from his testicles, and freeze that tissue for future use. Once he is an adult and free of cancer, if he is indeed infertile he could use the tissue in one of several ways.
None of these methods has yet produced the birth of a live baby, however.
Preserving Fertility in Men with Cancer
The tissue pieces could be thawed and put back into his testicle in the hopes that they would begin to produce sperm. This is a delicate process that would only work if his hormones were normal and his testicles were at a good temperature with a good supply of blood circulation. How it works: The woman who will carry the child must undergo hormone shots for several weeks to stimulate her ovaries to ripen more than one or two eggs. The woman's eggs are harvested or collected through a minor outpatient surgery. The harvested eggs are cleaned in the laboratory and stored in individual dishes to be ready for fertilization.
The embryologist uses a special microscope to choose a healthy-looking sperm and injects it into an egg. If all goes well, several embryos can be created. Usually just one or two embryos are placed into the uterus of the female partner in the hopes that they will implant and start a pregnancy. How it works: A man's semen sample is purified and concentrated to contain as many active sperm as possible. In a health care provider's office, the sample is put in a thin catheter tube and slipped directly through the woman's cervix into her uterus to give the sperm a head start on fertilizing the egg.
Sometimes the woman is given extra hormones to ripen more than one egg, but not in the high doses used in IVF. This is called superovulation. If an ultrasound shows that too many eggs are ripening, the insemination should either be canceled or the woman should have her eggs gathered and used for IVF instead. Otherwise there is a high risk of a multiple pregnancy, with all of its dangers for the mother and infants.
How it works: A man donates his sperm.
The survivor may choose someone that is known personally or much more commonly, the man or couples chooses a sperm donor who has worked with a donor sperm from a sperm bank. The donor may be similar to the man in ethnic background, coloring, etc. Most sperm donors in the United States prefer to remain anonymous, but many give the bank information about their hobbies and personalities. Their family and personal health histories are analyzed carefully to minimize the chance of an inherited disease.
The semen is used as in IUI to create a pregnancy. Anserini, P. Chiodi, S.