Male fertility preservation in cancer patients. Reasoned opinion

Every day about thirty cancers are diagnosed in young Italian patients. Of these, 37.4% are cases of young men mainly affected by testicular, colon-rectal or thyroid cancer, melanoma or Hodgkin’s lymphoma. The risk of infertility in some types of cancer is very high, but for others the risk is much lower. Due to numerous confounding factors, it is difficult to clarify a role of cancer itself in male fertility. Semen cryopreservation may represent the only chance of future genetic parenthood for many patients. Rapid freezing of semen in liquid nitrogen vapors, before cancer treatment is started, is considered the gold standard for male fertility preservation; nevertheless, no more than 10% of patients ask to use frozen sperm to obtain a pregnancy. Despite the efficacy of male fertility preservation methods, the rate of men achieving pregnancy with samples frozen prior to cancer treatment is about 3.9%. In this reasoned opinion, different reasons are given, which suggest the need for a personalized approach to male fertility preservation. KEY WORDS: Male fertility, fertility preservation, cryopreservation, sperm freezing, male cancers, fertility preservation efficacy, cancer patients.