What Men Need to Know About Prostate Cancer and Future Fertility

What Men Need to Know About Prostate Cancer and Future Fertility


What Men Need to Know About Prostate Cancer and Future Fertility
What Men Need to Know About Prostate Cancer and Future Fertility
Prostate cancer affects one out of each 6 men surviving in the US. Treatment of cancer of the prostate can markedly reduce fertility potential. Approximately, 217,000 these are expected being diagnosed with prostate cancer in the US really. Prostate cancer is diagnosed in 10 percent,000 men prior to the age of 39 and one in 40 between the ages of 40 and 59. Screening for cancer of the prostate using a blood tests-prostate specific antigen (PSA) ended in increased diagnosis in younger men. Many men diagnosed with cancer of prostate are interested in future fertility. Except in the event of distant spread, survival after prostate cancer approaches 100%. Prostate cancer is a lot more common in males carrying BRCA2 mutations and is situated younger age.

Cancer in men, before treatment, may affect sperm count and quality, even though this is controversial. In general 10% of men informed they have cancer are anticipated to have no ejaculated sperm-azospermia. Up to 50% could possibly have abnormal sperm quality.

What Men Need to Know About Prostate Cancer and Future Fertility
Prostate cancer treatment and future fertility. Treatment options for cancer of prostate include
1. Radical prostatectomy. This procedure can be through a large incision or via minimally access surgery-laparoscopy. Surgery could be modified to preserve the nerve fibers to blame for erection thus reducing male impotence after surgery. Surgery causes block from the vas deferens on both sides ultimately causing obstruction and azospermia.
2. Radiation. External beam radiation affect sperm production through the testes as scattered radiation can harm the sperm producing cells. Placing a radioactive seed within the prostate-brachytherapy, has minimal effect on sperm production.
3. Observation on;y is achievable for selected men diagnosed with prostate type of cancer.

Fertility preservation options in young men
1. Sperm Cyopreservation. Less than 50% of men clinically determined to have cancer preserve their sperm before treatment as a result of lack of information or counseling. This is a very available and inexpensive option. One or more samples may be frozen according to time and initial sperm counts and quality. Sperm can be frozen indefinitely. If multiple samples were frozen, they may be used for intrauterine insemination. If limited quantity of sperm is accessible or inferior -movement or sperm shape, IVF with injection of sperm into the egg-ICSI is essential. Sperm freezing carries a good psychological impact on men during cancer treatment.
2. Electro-ejaculation. For men who have impotence problems or inability to ejaculate after surgery, electrical stimulation can induce ejaculation. Sperm quality in cases like this is likely abnormal favoring the use of sperm for IVF-ICSI.
3. Testicular Sperm Extraction-TESE. Form men without ejaculated sperm-azospermia, sperm can be surgically obtained in the testes. This is also an option for men who cannot produce sperm with out sperm may be aspirated without surgery. This procedure can be during the surgical procedures for cancer. Sperm are obtained in 50-60% of males with azospermia. Sperm obtained are used for IVF with ICSI. Sperm can also be obtained in the duct that convey sperm outside the testes-Microsurgical epididymal sperm aspiration-MESA. The rate of success of achieving pregnancy using frozen ejaculated sperm or surgically obtained viable sperm is just not different from fresh sperm.

Checklist for fertility preservation in prostate type of cancer
  • Discuss along with your oncologist different cancer treatment options-radical prostatectomy, external beam radiation and brachytherapy or even observation only.
  • If radical prostatectomy is planned inquire about the technique of surgery-open or laparoscopy, nerve sparing procedures and incidence of male impotence in the surgeon's hands.
  • Ask for more information about the effects of prostate type of cancer treatment and fertility preservation options in the oncologist or reproductive endocrinologist.
  • If thinking about fertility preservation a reproductive endocrinologist or urologist can refer you for semen analysis and freezing (in the same time), interpret the semen analysis and advice concerning the number of samples to be frozen.
  • If no sperm found-azospermia, surgical sperm retrieval can be executed at the time of surgery for cancer or after cure.

Amr Azim is often a board certified reproductive endocrinologist and fertility specialist in New York City IVF and author of countless scientific publication inside the area of fertility treatment and fertility preservation. I focus on fertility counseling, testing,male factor infertility, PCOS, endometriosis and infertility treatments including IUI and IVF.
What Men Need to Know About Prostate Cancer and Future Fertility

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