Sterility and cancer Sterility and cancer
Sterility, also referred to as intractable infertility, is the inability to achieve pregnancy due to the absence of viable sperm (azoospermia) in males or mature eggs (menopause) in females. This condition may be diagnosed when conception does not occur despite assisted reproductive treatments. Cancer treatments, such as chemotherapy and radiation, can significantly contribute to sterility, with the risk varying based on cancer type, treatment methods, and individual factors like age and health. Symptoms of sterility often go unnoticed until an individual attempts to conceive, as conditions like azoospermia and menopause may not present clear signs without medical testing.
Diagnosis for male sterility typically involves semen analysis, while female sterility is assessed through hormone level evaluations and ultrasound examinations. Unfortunately, there are no established treatments for sterility resulting from these conditions. However, individuals facing cancer treatment are encouraged to explore fertility preservation options prior to undergoing therapy. These options can include sperm or egg freezing, embryo preservation, and potential fertility-sparing surgical techniques. Overall, understanding the implications of cancer treatments on fertility is essential for those affected, and proactive measures can help preserve reproductive options.
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Subject Terms
Sterility and cancer Sterility and cancer
ALSO KNOWN AS: Intractable infertility, azoospermia, menopause
Related condition:Infertility
DEFINITION: Sterility is the inability to achieve pregnancy due to the absence of viable sperm in the testicles (azoospermia) or an absence of mature, viable eggs in the ovaries (menopause). Sterility is often diagnosed when conception does not occur even after assisted reproductive technology treatments. Sterility can be caused by some cancer treatments.
Risk factors: The risk of sterility depends on the type of cancer and its location, the specific cancer treatment, and the use of any fertility-preservation or -sparing procedures before or during treatment. The risk of sterility is also affected by the person’s age, general health, and pretreatment fertility status.
Etiology and the disease process: Sterility can be caused by chemotherapy, especially alkylating agents; high doses of radiation to the entire body, cranium, abdomen, or pelvis; and surgical treatments that remove or damage reproductive structures.
Incidence: The occurrence of sterility is highly variable based on patient- and treatment-related factors. The frequency of sterility across all cancer patients is unknown.
Symptoms: Sterility is not often detected until a person attempts to conceive. Azoospermia is not evident without medical screening, but the inability to ejaculate or produce semen during ejaculation may be a symptom of sterility. The absence or cessation of menstruation is symptomatic of menopause. Still, female patients may continue to menstruate but remain infertile due to poor egg quality or lack of ovulation.
Screening and diagnosis: Male sterility is diagnosed through semen analysis and sometimes testicular to assess the presence of sperm. Female sterility is diagnosed by assessing hormone levels and an ultrasound examination for ovulation, usually after ovulation induction with fertility medications.
Treatment and therapy: There are no known treatments for sterility due to azoospermia or menopause. Sterility related to cancer treatments, such as surgery and chemotherapy, is often of less concern than addressing the cancer itself. There are ways, however, to protect fertility before cancer treatment begins.
Prognosis, prevention, and outcomes: It is advised that cancer patients consider fertility preservation or sparing options before treatment and consult a fertility specialist. Before treatment, men can have healthy sperm frozen for future use. Researchers are testing whether frozen testicular tissue or sperm stem cells transplanted back into the testicles can restore sperm production. Regardless, frozen sperm can be used for in vitro fertilization and intrauterine insemination. Women can have their eggs collected and fertilized in the laboratory, with the resulting embryos frozen for future use. Unfertilized eggs do not remain as viable for later use as do embryos. Ovarian tissue transplantation is a viable option, as is transplanting the ovaries to the abdomen for protection. Patients may benefit from fertility-sparing options during treatment, which include protecting reproductive organs from radiation, using conservative surgery when possible, choosing the least harmful forms of chemotherapy, and engaging in experimental hormonal therapy.
Bibliography
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