Chiba Koji, Fujisawa Masato
Division of Urology, Department of Surgery Related, Faculty of Medicine Kobe University Graduate School of Medicine 7-5-1 Kusunoki-Cho, Chuo-Ku 650-0017 Kobe Japan.
Reprod Med Biol. 2014 Apr 26;13(4):177-184. doi: 10.1007/s12522-014-0180-6. eCollection 2014 Oct.
Due to recent advances in medical technologies, cancer has become more curable and chronic, and post-treatment quality of life, including male fertility, has become an important issue. Cancer itself can affect spermatogenesis through complex interactions, and cancer treatment such as surgery, radiotherapy and chemotherapy, all have certain detrimental effects on spermatogenesis. Currently, sperm cryopreservation before cancer treatment is the mainstay of fertility preservation, and is recommended by numerous guidelines. Although fertility preservation should be discussed with all cancer patients before treatment, it still remains underused. Postpubertal patients who are unable to bank sperm may undergo testicular sperm extraction before treatment. For prepubertal boys, there is no clinically established guideline for fertility preservation. Investigations such as spermatogonial stem cell culture are ongoing, and may lead to clinical options for fertility preservation in the future.
由于医学技术的最新进展，癌症已变得更可治愈且呈慢性化，包括男性生育能力在内的治疗后生活质量已成为一个重要问题。癌症本身可通过复杂的相互作用影响精子发生，而诸如手术、放疗和化疗等癌症治疗方法，均对精子发生有一定的有害影响。目前，癌症治疗前的精子冷冻保存是生育力保存的主要手段，并且被众多指南所推荐。尽管在治疗前应与所有癌症患者讨论生育力保存问题，但该方法仍未得到充分利用。青春期后无法储存精子的患者可在治疗前进行睾丸精子提取。对于青春期前男孩，尚无临床确立的生育力保存指南。诸如精原干细胞培养等研究正在进行中，未来可能会带来生育力保存的临床选择。
