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Fatherhood Following Treatment for Testicular Cancer: A Systematic Review and Meta-Analyses.
Brigitte Gerstl1,2, Michael J Bertoldo3,4, Elizabeth Sullivan5
1Department of Biostatistics, The Kirby Institute, University of New South Wales, Sydney, Australia.
Journal of Adolescent and Young Adult Oncology
|April 8, 2020
Summary
Testicular cancer (TC) survivors have a 37% chance of fatherhood after treatment. Counseling on fertility impacts and recommending sperm banking before treatment are crucial for male cancer patients.
Area of Science:
- Oncology
- Reproductive Medicine
- Biostatistics
Background:
- Testicular cancer (TC) is the most common malignancy in males aged 15-34.
- Fertility preservation is a significant concern for young men diagnosed with TC.
- Understanding fatherhood rates post-treatment is vital for patient counseling.
Purpose of the Study:
- To systematically review and meta-analyze existing studies on fatherhood following TC treatment.
- To quantify the rates of pregnancy and successful fatherhood in TC survivors.
- To identify factors influencing reproductive outcomes after TC therapy.
Main Methods:
- Systematic literature search of Medline and Embase databases.
- Inclusion of studies reporting on TC patients and reproductive variables.
- Meta-analysis with fixed effects model and heterogeneity assessment (I² statistic).
Main Results:
- 27 studies were included in the meta-analysis.
- Pooled pregnancy rate was 22% (95% CI: 0.21-0.23) among couples conceiving after TC.
- Fatherhood was achieved by 37% (95% CI: 0.35-0.39) of males post-treatment.
- Miscarriage rate was 11% (95% CI: 0.07-0.16) among achieved pregnancies.
Conclusions:
- TC treatment can impact male fertility, necessitating proactive fertility discussions.
- Sperm banking should be recommended to all TC patients prior to treatment initiation.
- Comprehensive counseling regarding fertility and reproductive options is essential for TC survivors.
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