Table of contents:
- What are the effects of chemotherapy on male fertility?
- Options for maintaining male fertility cancer patients
- Use of an anti radiation shield
- Sperm storage (sperm bank)
- Clotting of testicular tissue
- Intracytoplasmic Sperm Injection (IVF-ICSI) IVF Program
- Intrauterine insemination
In addition to its positive properties to kill cancer cells, chemotherapy and other cancer treatments can cause a variety of unwanted side effects. For male cancer patients, one of the side effects of cancer treatment that may occur is fertility problems. But what if you and your partner want to try to conceive after cancer has been successfully fought? Is there a way to maintain or restore male fertility in cancer patients?
What are the effects of chemotherapy on male fertility?
Chemotherapy basically works by killing the body's cells that are dividing rapidly. Because sperm cells are cells that divide rapidly, in addition to cancer cells, sperm can easily be targeted and damaged by chemotherapy.
In addition, the decrease in male fertility in cancer patients or even infertility can be caused by chemotherapy drugs and other cancer therapy methods (immunotherapy, radiotherapy, stem cell grafts, etc.) attack the cells in the testes, causing obstruction / cessation of the production of testosterone and sperm cells. Cancer therapy can also damage nerves and blood vessels in the pelvic area, making it difficult for men to have an erection.
Cancer in general causes fertility problems only temporarily and male fertility can return again after recovering from cancer, but some types of cancer (Hodgkin's cancer, lymphoma or leukemia) and certain methods of treating cancer are at risk of causing fertility problems and even permanent infertility. Infertility is more likely in male cancer patients over the age of 40 because cell recovery is more difficult and tends to be imperfect.
Options for maintaining male fertility cancer patients
Here are some things you can do to maintain male fertility in cancer patients to have offspring at a later date:
Use of an anti radiation shield
Anti-radiation shields are used when undergoing radiation therapy on cancers that are close to the reproductive organs or around the pelvis. For example, earlier therapy for prostate cancer, testicular cancer, or colon cancer. The shield aims to reduce the impact of radiation on the testicular organs which can interfere with the sperm production process.
Sperm storage (sperm bank)
A sperm bank is a method of collecting and storing healthy sperm samples as an "investment" for the opportunity to have offspring in the future. Sperm can be collected and started to be stored once the risk of cancer is known or before cancer patients undergo chemotherapy and radiation. This can be done in men who have entered puberty or are at least 12-13 years old.
The method of collecting sperm is usually done by masturbating in a closed room at a fertility clinic, and the ejaculatory fluid that comes out is stored in a special container. The sperm sample needs to be stored at body temperature and needs to be preserved in a lab for about an hour. Sperm storage is done by freezing for future use. This storage method can last up to a count of 20 years without damage to the sperm.
Clotting of testicular tissue
The testicular tissue freezing method is still under development and further research. This method is aimed at boys who have not entered puberty and have not been able to produce sperm fluid. This procedure requires collecting and freezing testicular tissue before cancer treatment begins. This tissue contains stem cells and which can turn into sperm over time.
If the cancer patient proves to be infertile in adulthood, the testicular tissue will be thawed and transplanted again in the hope that he can return to producing sperm. However, other physical health factors also affect such as normal reproductive hormones, appropriate testicular temperature and adequate blood circulation to the testes.
Intracytoplasmic Sperm Injection (IVF-ICSI) IVF Program
ICSI IVF is a method used when the number of sperm cells in the ejaculatory fluid is too low to carry out fertilization. Fertilization method is carried out in vitro by injecting healthy sperm cells into female eggs. However, this method is quite difficult and is greatly influenced by the condition of the eggs produced by the female partner.
Women who are about to conceive and become pregnant on this method must undergo hormone injections within a few weeks to stimulate the ovaries to mature more than one egg. The egg is then surgically removed for fertilization with the sperm cell. If this process is successful it will produce an embryo and re-implant in the woman's uterus in the hope that it can develop and start the pregnancy process.
The IVF-ICSI method is costly and poses a risk to the health of the female partner. What's more, the success rate will be higher if women are young or under 35 years of age with good fertility rates.
Intrauterine insemination
Insemination is a method of injecting sperm using a catheter or a special tube that is inserted into the woman's uterus. The sperm cells used are taken as a concentrate from as many active sperm as possible. To increase the success of the sperm injection, it is carried out at the most fertile time for the female partner and can also be given additional hormones to make the insemination process successful.
However, the conditions of fertilization must be kept under control. Fertilizing too many eggs in a woman can be dangerous for the mother and the fetus in her womb so the process needs to be canceled. In addition, this method is only recommended if the condition of the sperm used tends to be good or close to normal fertility indicators.
