Dr. Darshan Patel - Sexual Dysfunction and Fertility | Testicular Cancer Conference 2024 presented by Fennec Pharmaceuticals

Dr. Darshan Patel - Sexual Dysfunction and Fertility | Testicular Cancer Conference 2024 presented by Fennec Pharmaceuticals

At the 2024 Testicular Cancer Conference presented by Fennec Pharmaceuticals, Dr. Darshan Patel of UC San Diego addressed fertility concerns in testicular cancer survivors and strategies to optimize reproductive outcomes.

Key Points:

  • Impact on Fertility:

    • Treatment Effects: Chemotherapy and radiation can impair sperm production by targeting rapidly dividing cells, including sperm.

    • Pre-Treatment Factors: Up to 25% of men may have reduced sperm counts even before treatment, especially with tumors larger than 4 cm.

  • Factors Affecting Reproductive Health:

    • Hormonal Changes: Low testosterone levels can hinder sperm production and sexual function.

    • Sexual Dysfunction: Erectile dysfunction and ejaculation issues can impede natural conception.

    • Psychosocial Stressors: Emotional and financial stresses can affect fertility decisions and outcomes.

  • Fertility Preservation:

    • Sperm Cryopreservation: Freezing sperm before treatment is effective and should be discussed early.

    • Counseling Gaps: Many men lack adequate counseling, particularly older individuals and those with lower socioeconomic status.

    • Utilization Rates: Only 24-30% of counseled men bank sperm; just 6-18% use it later.

  • Assisted Reproductive Technologies (ART):

    • Intrauterine Insemination (IUI): Thawed sperm is introduced into the partner's uterus; requires sufficient sperm count.

    • In-Vitro Fertilization (IVF): More involved and costly but offers higher success rates.

    • Success Rates: Paternity rates using ART range from 50-80%.

  • Post-Treatment Fertility Options:

    • Azoospermia After Chemotherapy: Micro-Testicular Sperm Extraction (Micro-TESE) can retrieve sperm directly from the testicle with about 50% success.

    • Ejaculatory Disorders: Medical therapies can address retrograde ejaculation; surgical options are available for other ejaculation issues.

  • Financial and Logistical Considerations:

    • Cost Barriers: Fertility preservation and ART can be expensive; longterm storage fees add up.

    • Storage Decisions: Patients should assess how long to store sperm based on reproductive goals.

Conclusion:

Dr. Patel emphasized the importance of early fertility preservation discussions before any cancer treatment begins. Personalized care, thorough counseling, and access to reproductive technologies are crucial for optimizing fertility outcomes in testicular cancer survivors. Addressing both medical and psychosocial factors enables patients to make informed decisions about their reproductive health.

The slides from Dr. Patel’s presentation can be downloaded here.

Testicular ConferenceTesticular Cancer Awareness Foundationtestes cancer, Testes Cancer, testicular cancer survivor, testicular cancer, testicular cancer awareness, conference, TC Conference Guest SpeakerComment