[Treatments of testicular cancer and protection of spermatogenesis].
The deleterious effects of chimio or radio-therapy on spermatogenesis of men treated for testicular cancer are well known. Retroperitoneal lymphadenectomy is a risk for ejaculation process. Semen cryopreservation seems to be obligatory before any deleterious treatment. Prophylactic measures do exist such as lead protection during x-rays therapy, drugs with less toxicity but similar efficiency, selective lymphadenectomy. Moreover, positive results were reported form realised in animals to protect spermatogenesis. In men treated for testicular cancer, 4 protective studies were reported using either GnRH analogs (3 studies) or medroxyprogesterone (one study). No protective effects were obtained in these trials, and the reasons for such failure are discussed. Finally, new potential possibilities of spermatogenesis protection are suggested supported by the results of animal experiments or the occurrence of new drugs such as use of steroids, GnRH antagonist or testicular hypothermia.
Bujan
L
L
Centre de Stérilité Masculine, CHU La Grave, Toulouse. bujan@cict.fr
Bachaud
J M
JM
Chevreau
C
C
Pontonnier
F
F
Mansat
A
A
Mieusset
R
R
D000970:Antineoplastic Agents / Q000009:adverse effects; D006801:Humans; D008297:Male; D011835:Radiation Protection; D012662:Semen Preservation / Q000379:methods*; D013091:Spermatogenesis / Q000187:drug effects / Q000528:radiation effects; D013736:Testicular Neoplasms / Q000628:therapy*
D000970:Antineoplastic Agents