Fertility preservation in men and prepubertal boys

Abstract

Managing the fertility potential has emerged as a major concern for young men who receive gonadotoxic therapy for various malignant and nonmalignant conditions. One of the major causes of non-accidental mortality worldwide is cancer. Over the past few decades, due to the development of reasonably effective cancer treatment regimens, survival rate among childhood cancer patients has increased. A recent estimate suggests that ~1 in 530 young adults between the ages of 20 and 39 years is a childhood cancer survivor. Unfortunately, the different cancer regimens like radiotherapy and/or chemotherapy employed to cure cancer also damage other healthy rapidly dividing cells such as the spermatogonial stem cells. Thus, cancer treatments become gonadotoxic and render patients to suffer subfertility or infertility. Infertility or subfertility due to cancer treatment may be reversible in some cases, whereas persistent infertility may occur in 50-95 % of malignancies. Hence, maintaining reproductive health or the ability to father a normal biological child post-cancer treatment becomes of paramount concern in cancer survivors. To tackle these issues the area of fertility preservation has emerged as an option to maintain reproductive potential to all those who receive gonadotoxic treatments.