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The impact of chemotherapy on male fertility: a survey of the biologic basis and clinical aspects.

机译：化学疗法对男性生育力的影响：生物学基础和临床方面的调查。

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The introduction of cisplatin-based polychemotherapy has led to cure rates of up to 90% for the most frequent malignant diseases seen in young men. In view of these high cure rates, increasing clinical importance is now being attached to chemotherapy-induced fertility disorders. Comparative studies examining the impact of cytotoxic chemotherapy on gametogenesis demonstrate significant cytostatic- and dose-specific differences. The extensive literature on possible teratogenic effects of chemotherapy provides no evidence suggesting that offspring of patients with a history of chemotherapy have an increased risk of malformations. However, these studies, the scope and follow-up of which may still be inadequate, have failed to eliminate the fear of such risk. Hormonal protection from chemotherapy-induced testicular damage has thus far succeeded only in animal models pretreated by application of gonadotropin-releasing hormone agonists combined with nonsteroidal antiandrogens or testosterone plus 17beta-estradiol. The same holds true for hormone therapy aimed at stimulating the recovery of spermatogenesis after chemotherapy-induced testicular damage. Cryopreservation of germ cells can be suggested to patients undergoing cytostatic therapy. In some cases, testicular extraction of spermatozoa can also be offered as a novel approach.
机译：基于顺铂的多化学疗法的引入已使年轻男性中最常见的恶性疾病治愈率高达90％。鉴于这些高治愈率，如今化学治疗引起的生育障碍日益受到重视。比较研究，研究细胞毒性化学疗法对配子发生的影响，结果显示出明显的细胞抑制和剂量特异性差异。关于化学疗法可能致畸作用的大量文献没有提供证据表明具有化学疗法史的患者的后代有畸形风险增加。但是，这些研究的范围和后续行动可能仍然不足，未能消除对此类风险的恐惧。迄今为止，仅在通过应用促性腺激素释放激素激动剂与非甾体类抗雄激素或睾丸激素加17β-雌二醇联合治疗的动物模型中，才成功获得了由化疗引起的睾丸损伤的激素保护。对于旨在刺激化疗引起的睾丸损伤后刺激精子恢复的激素疗法也是如此。可以建议接受细胞抑制疗法的患者进行生殖细胞的冷冻保存。在某些情况下，精子的睾丸提取也可以作为一种新方法提供。

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