2005 © Oxford University Press
Disruption of Spermatogenesis by the Cancer Disease Process
Affiliation of authors: Center for Advanced Research in Human Reproduction, Infertility and Sexual Function, Glickman Urological Institute and Department of ObstetricsGynecology, Cleveland Clinic Foundation, Cleveland, OH
Correspondence to: Ashok Agarwal, PhD, HCLD, Professor of Surgery and Director of the Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Glickman Urological Institute and Department of Obstetrics Gynecology, The Cleveland Clinic Foundation, 9500 Euclid Ave., Desk A19.1, Cleveland, OH 44195 (e-mail: agarwaa{at}ccf.org).
In the past, cancer survivors tended to be most concerned about disease recurrence and treatment side effects. As survival rates have increased, however, patients are now also concerned about quality-of-life issues such as preserving fertility potential. It is well known that cancer treatment adversely affects male fertility via direct effects on the testis and/or through the endocrine glands. Evidence also suggests that the disease process itself may affect a man's fertility by influencing spermatogenesis. However, the causes of poor semen quality in cancer patients are not well understood. Multiple factors are likely involved, including preexisting defects in germ cells, systemic effects of cancer, and endocrine and immunological disturbances. This paper will summarize available evidence on different factors involved in impaired spermatogenesis in patients with various cancers with emphasis on testicular cancer and Hodgkin lymphoma. Cryopreservation of spermatozoa is a simple and practical approach available to all patients with cancer who wish to preserve their fertilizing potential before cancer therapy.
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