Application of spermatogenesis suppression therapies for fertility preservation

Introduction The lifetime risk of development of cancer for individuals in the United States is 40%, and treatment commonly involves the use of chemotherapy and/or radiotherapy. These cytotoxic cancer treatments have a significant impact on a patient's future fertility status, which is of particular concern to cancer patients of childbearing age. The ability to achieve a pregnancy may be temporarily diminished, forcing the patient to delay parenthood, or infertility may become permanent. Loss of potential fertility can be an especially devastating consequence to a patient, in light of other physical and emotional turmoil entailed in cancer treatment. Clinical manifestations of male infertility as a result of chemotherapy or radiotherapy include potential oligo/azoospermia and occasionally androgen insufficiency. There is a significant effort to enhance patients’ awareness of these sequelae and to ensure that physicians are adequately informing patients of the consequences. In addition, efforts are ongoing to investigate strategies for preventing loss of gonadal function before and restoring gonadal function after cytotoxic treatment. Various therapeutic interventions have been studied in both animal models and humans; in particular, researchers’ focus has centered on hormonal modulation [1]. Manipulation of the endocrine system to prevent or reverse damage to male germline cells is the focus of this chapter.