In addition to its positive efficacy in killing 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 might occur is fertility problems. But what if you and your partner want to try to get pregnant after the cancer has been successfully resisted? Is there a way to maintain or restore male fertility of cancer patients?
What are the effects of chemotherapy on male fertility?
Chemotherapy basically works by killing cells that divide rapidly. Because sperm cells are cells that divide rapidly, then apart from sperm cancer cells can be easily targeted and damaged by chemotherapy.
In addition, a 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 cells in the testis, causing inhibition of production of sperm cells. Cancer therapy can also damage nerves and blood vessels in the pelvic area, making it difficult for men to erect.
Cancer in general causes fertility disorders only for a while and male fertility can return after recovering from cancer, but some types of cancer (cancer of Hodgkin's disease, lymphoma or leukemia) and certain methods of handling cancer risk causing fertility disorders and even permanent infertility . Infertility is more likely to occur in men with cancer patients over the age of 40 because cell recovery is more difficult and tends to be imperfect.
Options for maintaining male fertility in cancer patients
Here are some things that can be done to maintain the fertility of male cancer patients to obtain offspring in the future:
Use of an anti-radiation shield
Anti-radiation shields are used when undergoing radiation therapy in cancer adjacent to the reproductive organs or around the pelvis. For example, the 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)
Sperm bank is a method of taking and storing healthy sperm samples as an "investment" for the opportunity to obtain offspring in the future. Sperm can be taken and started to be stored once the risk of cancer is known or before cancer patients undergo chemotherapy and radiation. This can be done for men who have entered puberty or at least 12-13 years old.
The method of sperm collection is usually done by masturbation 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 in body temperature and needs to be preserved in the lab for about one hour. Sperm storage is done by freezing for future use. This storage method can last up to 20 years without damage to sperm.
Freezing of testicular tissue
Freezing testicular tissue methods that are still under development and further research. This method is intended for boys who have not entered puberty and cannot produce sperm fluid. This procedure requires to take and freeze testicular tissue before cancer treatment begins. The network contains stem cells and that can turn into sperm as time goes on.
If the cancer patient proves to be infertile at adulthood, the testicular tissue will be thawed and re-transplanted in the hope that he can re-produce sperm. However other physical health factors also influence 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 ejaculate fluid is too little to fertilize. The fertilization method is carried out in vitro by injecting healthy sperm cells into the female egg. But this method is fairly difficult and is strongly influenced by the condition of the egg cells produced by female partners.
Women who will experience conception and pregnancy in this method must undergo hormone injections within a few weeks to stimulate the ovaries to harvest more than one egg. The egg is then taken by surgery for fertilization with sperm cells. If this process is successful it will produce an embryo and re-implant in the female uterus in hopes of developing and starting the pregnancy process.
The IVF-ICSI method costs a lot and risks the health of female partners. Moreover the success rate will be higher if women are still young or under 35 years of age with good fertility.
Insemination is a method of injecting sperm using a special catheter or tube inserted into a woman's womb. The sperm cells used are taken as much concentrate as possible from active sperm. To increase the success of sperm injections carried out at the most fertile time for female partners and also can be given additional hormones so the insemination process is successful.
However, the condition of fertilization must be controlled. Fertilization of eggs in women that are too much can be dangerous for the mother and fetus in the 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 the normal fertility indicator.
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