INRS researchers conducted a study to know how chemotherapy for cancer treatment affects male fertility. The effects of treatment have been observed separately before and after puberty. When the boys reach the age of puberty, their testicles start making to produce sperms. If cancer treatments are given during childhood, they affect sperm production by damaging testicles and lead to infertility.
Geraldine Delbes is a professor at the Institute National de la Research Scientifique (INRS) in Laval said that if the cancer treatment is given to boys during their preadolescent age then no effects will be seen because the testicles would be in “dormant phase” in this age.
It is not true; testicles are not immune to chemotherapy if it is given before puberty. As chemotherapy kills the rapidly dividing cells in the body and sperms are dividing quickly in prepubescent boys so they are easily damaged by the chemotherapy. But still, long terms effects on testicles due to chemotherapy have not been well known.
A pilot study was conducted by Professor Delbes (specialist in reproductive toxicology) in collaboration with fertility specialists and oncologists from the McGill University Health Center (MUHC). This study is a cohort study that includes 13 patients with pediatric lymphoma and leukemia. The study was conducted to answer the questions raised about the effects of chemo on male fertility and long-term quality of life in cancer patients.
Professor Delbes further added that the study is unique in the sense that it separately observed the effects of chemotherapy in cancer survivors before and after puberty. It was concluded that the effects of chemotherapy do not depend on the age of the person. The prepuberty boys are at a greater risk of infertility because they have a low amount of produced sperms. It is clearly understood that no age or period is defined when the boys are insensitive to chemotherapy and show no effects of toxicity.
It was already shown by the large epidemiological studies that chemotherapy in pediatric cancer patients affects the male fertility and produced long term effects. But it is not clearly understood that which type of treatment affects sperm production and quality.
Researchers performed an analysis of the sperms of adult survivors with pediatric lymphoma or leukemia. They observed DNA damage and spermograms in the sperms and then compared these parameters with the cancer patients who were diagnosed before puberty and with the men who have no history of cancer.
Mixtures of many types of chemotherapy agents have been given to the cancer patients enrolled in the cohort study such as alkylating agents. These agents reduce the production of sperm in the long run.
Geraldine Delbes in her lab observed the anthracyclines agents particularly, as these anthracyclines are used for cancer treatment. It was shown by researchers they anthracyclines should not have any long-term effects on sperms quantity, but it could affect the quality of sperm.
Professor Delibes further explains that if anthracyclines are used for the treatment of cancer in the patients it would interfere with the chromatin and sperm DNA and cause long term abnormalities. These abnormalities cause infertility problems along with poor embryonic development.
Dr. Peter Chan who is co-author of the study and the Director of Male Reproductive Medicine in the Department of Urology at MUHC explains that the study has limitations because it involves less sample size but the data collected from the sample is specially related to males whose sperm banking may be difficult. Further research is needed to validate the results of this preliminary research.
Professor Delbes added that it is important to take care of the fertility of a childhood boy while giving him cancer treatment as medical staff ignores the fertility problem until he becomes an adult. The main priority is to preserve the fertility of men and cure them.
Further research is needed to highlight the effects of chemotherapy on the male fertility. It is important to give awareness and education to pediatric cancer patients about the long-term effects of chemotherapy without considering the age of diagnosis.