El Càncer testicular : gestió i tractaments per la preservació de la fertilitat

Abstract

Testicular cancer is the most common tumor in young men between 15 and 39 years of age. Despite its incidence in the male population has increased considerably in recent years, this illness has shown a very high survival rate. However, both cancer and its treatments (surgery, chemotherapy and radiotherapy) negatively affect patients' fertility. For this reason, fertility preservation techniques have become one of the main objects of study.

For carrying out this study, the most outstanding original investigations published in the last 5 years (2018-2023) will be reviewed in order to show the latest studies and advances related to this subject .The objective of this project is to review the current techniques used to preserve fertility, to explain the impact of cancer on fertility and to assess the counselling that patients recieve. The search for bibliographic resources was carried out using the PubMed database (MEDLINE) with the keywords “Testicular Cancer” and “Fertility Preservation”.

By reading the bibliography, it has been observed that cancer affects both the quality and the quantity of the spermatozoa of patients diagnosed with testicular cancer. Sperm cryopreservation is considered to be the most used method for fertility preservation. However, in certain cases this procedure can not be performed due to the impossibility of obtaining a sperm sample with functional mature spermatozoa. In pediatric patients, for example, sperm cryopreservation is not an option. In these cases, biopsies of the testicular tissue are performed, although, at the moment, no method has yet been approved to use these tissues in the future. Additionally, it has been determined that good counselling from the oncologist before treatment is decisive. Finally, the need to focus research on the possible uses of immature testicular tissue with the objective of preserving pre-pubertal patient’s fertility and the urgency for optimizing the techniques currently used is highlighted as the most important factor to take into account