Afternoon Symposium - Oncofertility I - Male
Time:4:15 pm - 6:15 pm
Location:HCC312 - Hawaii Convention Center
Robert E. Brannigan, M.D. (Chair), Northwestern University Feinberg School of Medicine
John P. Mulhall, M.D., Memorial Sloan Kettering Cancer Center
James F. Smith, M.D., UC San Francisco
Supported by an educational grant from Ferring Pharmaceuticals, Inc.
Needs Assessment and Description
Cancer therapies can have permanent, deleterious effects on male reproductive potential. Health-care providers must have an awareness of the impact of cancer and cancer treatments on male reproductive potential, and they must also understand how to deliver effective fertility preservation care to males across the age spectrum. This symposium, which will comprehensively address fertility preservation in males, is aimed at the target audience of urologists, andrologists, reproductive endocrinologists, nurses, and laboratory professionals.
At the conclusion of this session, participants should be able to:
- Describe key aspects of the American Society of Clinical Oncology Fertility Preservation recommendations.
- Discuss state-of-the-art fertility preservation procedures for male oncology patients across the age spectrum.
- Overview the investigational methods being studied for fertility preservation in prepubertal males.
A 32-year-old male with a solitary left testicle presents with a firm, nontender 3 cm left testicular mass. Alpha- fetoprotein (AFP) and beta-human chorionic gonadotropin (b-hCG) tumor markers are both significantly elevated, and imaging reveals left retroperitoneal adenopathy. He wants to father numerous biological children in the future. He provides 2 ejaculated semen samples for fertility preservation; both samples reveal severe oligoasthenoteratospermia (200,000 sperm/mL; 30% motility; 3% normal morphology for each specimen), and 2 vials of sperm are cryopreserved. He then undergoes a left radical orchiectomy, and pathology reveals a mixed germ cell tumor. After completion of a platinum-based chemotherapy regimen, he and his wife decide to pursue a pregnancy. He asks about the use of his cryopreserved sperm in the future. After participating in this session, in my practice I will:
a. Encourage him and his partner to undergo preimplantation genetic diagnosis at the time of in vitro fertilization (IVF) due to the increased risk of genetic anomalies in the offspring of oncology patients.
b. Counsel him that reproductive outcomes (fertilization, pregnancy, live-birth rates) for cryopreserved sperm from oncology patients are similar to outcomes for sperm from non-oncology patients.
c. Encourage him and his partner to undergo intrauterine insemination as a first step because it is less invasive than IVF/ intracytoplasmic sperm injection (ICSI).
d. Discourage him from using his sperm until he has greater than 5-year cancer survival due to his risk of relapse and death.
e. Not applicable to my area of practice