Male Cancer Patients and Infertility: A Literature Review

The survival rate for young male cancer patients has increased significantly over the last two decades due to early detection and advanced treatment methods. Currently, over 75% of youth with cancer are long-term survivors. With this improved survival rate, the quality of life has become a crucial consideration for both childhood and adult cancer survivors, particularly regarding fertility preservation. The most common cancers affecting individuals of reproductive age include leukemia, Hodgkin’s lymphomas, and testicular germ cell tumors. Chemotherapy and radiation therapy often have detrimental effects on fertility. As a result, cryopreserving semen before the beginning of cancer treatment has become the standard method to safeguard future male fertility. It is worth considering that for a significant number of male cancer patients, sperm health could be an issue even before their diagnosis, with research indicating that around 12% may not have viable sperm for freezing. The cytotoxic nature of cancer treatments can cause temporary or permanent damage to spermatogenesis, and the extent of damage depends on the combination and cumulative dose of drugs used. Certain chemotherapy drugs, including cyclophosphamide and procarbazine, can have severe effects on reproductive health, particularly damaging germ cells. Similarly, radiation therapy, particularly whole-body treatments, may lead to irreversible sterility. Various factors, including the tumor type, initial fertility status, and the specific cancer treatment regimen, influence the potential for future fertility in male cancer survivors. Post-treatment, many men turn to artificial reproductive techniques, such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), to achieve fatherhood. It is estimated that approximately 15% of males will make use of their cryopreserved semen due to persistent azoospermia following cancer treatment. The success rates of treatment with cryopreserved semen are typically favorable and comparable to standard IVF and ICSI outcomes.