Testicular function and fertility preservation after treatment for haematological cancer

Kirsi Jahnukainen, Rod T Mitchell, Jan-Bernd Stukenborg

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE OF REVIEW: Treatment for high-risk or relapsed haematological malignancy with haematopoietic stem cell transplantation is known to cause infertility. Today, there are no established options for fertility preservation in pre-pubertal boys. This review aims to describe how therapy for haematological malignancy in childhood affects male fertility, and to summarize recent developments for fertility preservation in these patients.

RECENT FINDINGS: Eventual recovery of spermatogenesis is probable after chemotherapy-based conditioning for haematopoietic stem cell transplantation. However, conditioning with total body irradiation is associated with a very high risk of permanent infertility. For high-risk patients, auto-transplantation of cryopreserved testicular tissue or cells might represent an approach for fertility preservation; however, contamination of testis tissue with malignant cells may prevent their subsequent reintroduction into patients. Recent progress using in-vitro differentiation of germ cells combined with assisted reproductive techniques may, in the future, represent a suitable alternative to retransplantation.

SUMMARY: Particular care must be taken when assessing infertility risk in patients with haematological malignancy as reclassification to high risk may significantly increase the likelihood of treatment-related gonadotoxicity. Importantly, development of fertility preservation strategies in such high-risk patients must also take into account specific risks for haematological cancers including cancer cell contamination.

Original languageEnglish
Pages (from-to)217-23
Number of pages7
JournalCurrent Opinion in Endocrinology, Diabetes and Obesity
Volume22
Issue number3
DOIs
Publication statusPublished - Jun 2015

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