Dear Editor,Allogeneic or autologous hematopoietic stem cell transplantation(HSCT)concerns an increasing number of patients.Worldwide,89070 allogeneic and autologous HSCT procedures were reported in 2016,representing ...Dear Editor,Allogeneic or autologous hematopoietic stem cell transplantation(HSCT)concerns an increasing number of patients.Worldwide,89070 allogeneic and autologous HSCT procedures were reported in 2016,representing a 7%increase per year since 1991.1 Improved transplant strategies and therapeutic efficacy have made HSCT a curative option for various indications,mostly comprising malignant blood cell pathologies but also including solid tumors or benign conditions.2 The conditioning regimen for transplantation often includes alkylating agents and/or total body irradiation(TBI).2 These treatments usually lead to permanent infertility.3 In men,the consequences include the impairment and reduction of Sertoli and Leydig cells,leading to the suppression of the spermatogonia pool and increased release of gonadotrophin.3 Although sperm banking can mitigate the risk of infertility.展开更多
Advances in the oncology field have led to improved survival rates.Consequently,quality of life after remission is anticipated,which includes the possibility to conceive children.Since cancer treatments are potentiall...Advances in the oncology field have led to improved survival rates.Consequently,quality of life after remission is anticipated,which includes the possibility to conceive children.Since cancer treatments are potentially gonadotoxic,fertility preservation must be proposed.Male fertility preservation is mainly based on ejaculated sperm cryopreservation.When this is not possible,testicular sperm extraction(TESE)may be planned.To identify situations in which TESE has been beneficial,a systematic review was conducted.The search was carried out on the PubMed,Scopus,Google Scholar,and CISMeF databases from 1 January 2000 to 19 March 2020.Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)recommendations were followed in selecting items of interest.Thirty-four articles were included in the systematic review,including 15 articles on oncological testicular sperm extraction(oncoTESE),18 articles on postgonadotoxic treatment TESE and 1 article on both oncoTESE and postgonadotoxic treatment TESE.Testicular sperm freezing was possible for 42.9%to 57.7%of patients before gonadotoxic treatment and for 32.4%to 75.5%of patients after gonadotoxic treatment,depending on the type of malignant disease.Although no formal conclusion could be drawn about the chances to obtain sperm in specific situations,our results suggest that TESE can be proposed before and after gonadotoxic treatment.Before treatment,TESE is more often proposed for men with testicular cancer presenting with azoospermia since TESE can be performed simultaneously with tumor removal or orchiectomy.After chemotherapy,TESE may be planned if the patient presents with persistent azoospermia.展开更多
文摘Dear Editor,Allogeneic or autologous hematopoietic stem cell transplantation(HSCT)concerns an increasing number of patients.Worldwide,89070 allogeneic and autologous HSCT procedures were reported in 2016,representing a 7%increase per year since 1991.1 Improved transplant strategies and therapeutic efficacy have made HSCT a curative option for various indications,mostly comprising malignant blood cell pathologies but also including solid tumors or benign conditions.2 The conditioning regimen for transplantation often includes alkylating agents and/or total body irradiation(TBI).2 These treatments usually lead to permanent infertility.3 In men,the consequences include the impairment and reduction of Sertoli and Leydig cells,leading to the suppression of the spermatogonia pool and increased release of gonadotrophin.3 Although sperm banking can mitigate the risk of infertility.
文摘Advances in the oncology field have led to improved survival rates.Consequently,quality of life after remission is anticipated,which includes the possibility to conceive children.Since cancer treatments are potentially gonadotoxic,fertility preservation must be proposed.Male fertility preservation is mainly based on ejaculated sperm cryopreservation.When this is not possible,testicular sperm extraction(TESE)may be planned.To identify situations in which TESE has been beneficial,a systematic review was conducted.The search was carried out on the PubMed,Scopus,Google Scholar,and CISMeF databases from 1 January 2000 to 19 March 2020.Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)recommendations were followed in selecting items of interest.Thirty-four articles were included in the systematic review,including 15 articles on oncological testicular sperm extraction(oncoTESE),18 articles on postgonadotoxic treatment TESE and 1 article on both oncoTESE and postgonadotoxic treatment TESE.Testicular sperm freezing was possible for 42.9%to 57.7%of patients before gonadotoxic treatment and for 32.4%to 75.5%of patients after gonadotoxic treatment,depending on the type of malignant disease.Although no formal conclusion could be drawn about the chances to obtain sperm in specific situations,our results suggest that TESE can be proposed before and after gonadotoxic treatment.Before treatment,TESE is more often proposed for men with testicular cancer presenting with azoospermia since TESE can be performed simultaneously with tumor removal or orchiectomy.After chemotherapy,TESE may be planned if the patient presents with persistent azoospermia.
