from Section 4 - Fertility Preservation Strategies in the Male
Published online by Cambridge University Press: 27 March 2021
Over the last several decades, survival rates for childhood cancer have steadily increased. In fact, with the overall cure rate for pediatric malignancies now approaching 80%, current estimates indicate that one in every 640 young adults in the United States will be a survivor of childhood cancer [1]. Unfortunately, many survivors struggle with medical side effects of their treatment including disorders of the endocrine system, cardiac and pulmonary dysfunction, secondary neoplasms, and infertility. Gonadal damage is a relatively common consequence of the treatments used to cure pediatric cancer. The extent of cytotoxic germ cell damage depends on the specific chemotherapeutic agents used and the cumulative doses received. Alkylating agents (particularly cyclophosphamide, ifosfamide, nitrosureas, chlorambucil, melphalan, busulfan, and procarbazine) are the most common class of drugs known to effect gonadal function and their impact has been studied extensively [2]. Additionally, the testes have a very low threshold for radiation exposure, and even small doses are known to be gonadotoxic. As treatment regimens for pediatric oncologic malignancies have improved, more and more survivors are entering their reproductive years [3].
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