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Testicular Function of Childhood Cancer Survivors: Who Is Worse?

Ylenia Duca1, Andrea Di Cataldo2, Giovanna Russo2

  • 1Andrology and Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Journal of Clinical Medicine
|December 19, 2019
PubMed
Abstract

Insights

Childhood cancer survivors face long-term infertility risks. Specific treatments like chemotherapy and stem cell transplants, along with Hodgkin's disease, significantly impair male reproductive function, necessitating fertility preservation strategies.

Area of Science:

  • Reproductive endocrinology
  • Pediatric oncology
  • Cancer survivorship

Background:

  • Childhood cancer survival rates have improved due to multidisciplinary care.
  • Antineoplastic treatments increase long-term toxicities, including hypogonadism and infertility in survivors.
  • Assessing reproductive health is crucial for young adult survivors of childhood cancers.

Purpose of the Study:

  • To identify patient subgroups at higher risk of adult reproductive dysfunction.
  • To analyze the impact of diagnosis, therapy, and age at treatment on gonadal function.
  • To guide fertility preservation strategies for at-risk childhood cancer survivors.

Main Methods:

  • Morpho-volumetric testicular assessment in 102 survivors.
  • Evaluation of hypothalamic-pituitary-gonadal axis endocrine function.
  • Analysis of sperm parameters in young adult survivors.

Main Results:

  • One-third of survivors exhibited low testicular volume, low testosterone, or altered sperm count.
  • Hodgkin's disease, stem cell transplantation, and chemotherapy with irradiation were linked to poor gonadal function.
  • Testicular volume predicted spermatogenesis better than FSH; AMH was not a reliable indicator.

Conclusions:

  • Pre-pubertal childhood cancer patients at high risk for infertility should be considered for testicular tissue cryopreservation.
  • Early identification of risk factors is essential for proactive fertility management.
  • Further research into long-term reproductive outcomes is warranted.
Keywords:
azoospermiachemotherapychildhood cancer survivorshypogonadisminfertilityleukemialymphomaradiotherapystem cell transplantationtesticular volume

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