Abram McBride J, Lipshultz Larry I
Division of Male Reproductive Medicine and Surgery, Scott Department of Urology, Baylor College of Medicine, 6624 Fannin St, Suite 1700, Houston, TX, 77030, USA.
Curr Urol Rep. 2018 May 17;19(7):49. doi: 10.1007/s11934-018-0803-2.
With improvements in cancer treatment outcomes and an increase in cancer survivorship, understanding the importance of fertility preservation options prior to undergoing cancer treatment is essential. Therefore, we review herein the effect of cancer and its treatment on male fertility, the rationale for sperm cryopreservation, options for sperm retrieval, ART outcomes, and experimental options.
Recent data update fertility outcomes with newer cancer therapies and provide longitudinal insight into survivor paternity with and without fertility preservation. Likewise, updated ART outcomes and future preservation options are discussed. The effect of cancer and its treatment on spermatogenesis is well established. Sperm cryopreservation is the best pre-treatment insurance for the opportunity of future fertility. Post-therapy patients may also achieve fertility restoration with ART, using cryopreserved or freshly obtained sperm. Meanwhile, utilization of cryopreserved testicular stem cells for future transfer or for in vitro maturation represents exciting alternatives on the horizon.
随着癌症治疗效果的改善和癌症幸存者数量的增加,了解在接受癌症治疗前保留生育能力的重要性至关重要。因此,我们在此综述癌症及其治疗对男性生育能力的影响、精子冷冻保存的基本原理、精子获取的方法、辅助生殖技术的结果以及实验性方法。
近期数据更新了采用新型癌症疗法后的生育结果,并提供了有无生育力保存情况下幸存者生育情况的纵向见解。同样,也讨论了辅助生殖技术的最新结果和未来的保存方法。癌症及其治疗对精子发生的影响已得到充分证实。精子冷冻保存是未来生育机会的最佳治疗前保障。治疗后的患者也可以使用冷冻保存或新鲜获取的精子,通过辅助生殖技术恢复生育能力。与此同时,利用冷冻保存的睾丸干细胞进行未来移植或体外成熟是即将出现的令人兴奋的替代方法。