Gonadotoxicity of Cancer Therapies in Pediatric and Reproductive-Age Males

Recent epidemiological studies estimate that approximately 1 in every 1,300 young males in the United States is a childhood cancer survivor [ 1 ] . Of this population, approximately 30% received gonadotoxic cancer treatments that resulted in permanent infertility [ 2 ] . Therefore, approximately 1 in every 5,000 young males is at risk for infertility due to their pediatric cancer treatment. This is in large part because of the sensitivity of male germ cells to injury by cytotoxic drugs and radiation therapy (RT). Germ cells that produce spermatozoa are more sensitive to chemotherapy and radiation compared to Leydig cells that generate testosterone [ 3 ] . Thus, a common late effect of cancer therapy for male patients is infertility rather than impaired pubertal development or impaired sexual function [ 4 ] .