Sperm quality unaffected by one course of radiation therapy or chemotherapy for early testicular cancer


Men with early stage testicular cancer can safely receive one course of chemotherapy or radiotherapy after surgery without it having a long-term effect on their sperm count, according to a study published in the leading cancer journal Annals of Oncology [1] on February 25.

Although it is known already that several rounds of chemotherapy or high doses of radiotherapy given to men with more advanced testicular cancer can reduce sperm count and concentration, it has been unclear whether a single cycle of chemotherapy or radiotherapy would have a similar effect in men with stage I disease.

Dr, Kristina Weibring, a cancer doctor at the  Hospital in Stockholm, Sweden, who led the study, said: “We wanted to examine in more detail if postoperative  treatment, given to decrease the risk of recurrence after the removal of the tumorous testicle, would affect the sperm count and sperm concentration long term in testicular cancer patients with no spread of the disease. To our knowledge, no such study has been done before.

“This is important to find out, since treatment with one course of postoperative chemotherapy has been shown to decrease the risk of relapse substantially, thereby reducing the number of patients having to be treated with several courses of chemotherapy.”

Testicular cancer is the most common cancer in young men between the ages of 15 and 40. When it is diagnosed, all patients have the testicle containing the tumour removed, a surgical procedure called orchiectomy.

In this study, 182 men aged between 18 and 50, diagnosed with stage I testicular cancer and who had had an orchiectomy within the past five years, took part in the study between 2001 and 2006. They were treated either in Stockholm or Lund. After surgery, they received radiotherapy (14 fractions of 1.8 Gy each, up to a total dose of 25 Gy) or one course of chemotherapy, or were managed by surveillance, meaning there was no postoperative treatment. They provided semen samples after orchiectomy but before further treatment, and then six months, one year, two years, three years and five years thereafter. From 2006 onward, radiotherapy was no longer used as a standard treatment in Sweden because of the risk of causing secondary cancer.

“We found no clinically significant detrimental long-term effect in either total sperm number or sperm concentration, irrespective of the type of postoperative treatment received,” said Dr Weibring. “Among men who received radiotherapy, there was a distinct decrease in average sperm number and concentration six months after treatment, though not in those who received chemotherapy. However, sperm number and concentration recovered in the radiotherapy group after six months, and continued to increase in all groups up to five years after treatment.

“I am very excited to see these results as I wasn’t expecting sperm to recover so well after postoperative treatment. I didn’t expect as negative an effect as if the patient had received many courses of chemotherapy, since it is much more toxic, but I was not sure how much the sperm would be affected by one course.

“With the results of this study we can give the patients more adequate information on potential side effects from postoperative treatment. Testicular cancer patients are often young men wanting to father children at some point, and we find, in many cases, that the patients are afraid of the potential risk of infertility caused by chemotherapeutic treatment. These findings should provide some reassurance to them.”

A well-known problem for men diagnosed with testicular cancer is an impaired ability to create sperm. A condition called testicular dysgenesis syndrome, characterized by poor semen quality among other things, may play a role in this and is also associated with a higher risk of developing testicular cancer. In addition, the orchiectomy and the cancer itself may also affect sperm quality. The removal of one testicle does not necessarily affect a man’s sperm count and concentration as the remaining testicle can compensate.

Dr Weibring concluded: “Our results are promising but more studies are needed, and we still recommend sperm banking before orchiectomy as a number of patients may have low sperm counts at the time of diagnosis that persists after postoperative treatment. In addition, the type of testicular cancer and whether or not it will need further treatments are unknown factors before the orchiectomy. Assisted reproductive measures may be necessary for these patients regardless of any treatment given.”

Editor-in-chief of Annals of Oncology, Professor Fabrice André, Professor in the Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France, commented: “This study, together with other research efforts, explores the paths to recovering a normal life after cancer. The finding that one course of chemotherapy has minimal impact on sperm count offers hope for thousands of patients worldwide, but we all must keep in mind that these data are preliminary and will require validation before we can use them in clinics. The next step will be to establish how to predict the toxic effects on sperm count of different chemotherapy regimens.”

REFERENCE

[1] “Sperm count in Swedish clinical stage I testicular cancer patients following adjuvant treatment”, by Kristina Weibring et al. Annals of Oncology. doi:10.1093/annonc/mdz017

The research was supported by grants from the Swedish Government Funding for Clinical Research, the Swedish Cancer Society, Gunnar Nilsson’s Cancer Fund, Malmo University Hospital Foundation for Cancer Research and Foundation for Urological Research, and King Gustaf V’s Jubilee Fund for Cancer Research.

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Sperm quality in dogs is rapidly declining, and it could be a big warning for human fertility


Food packaging chemicals have been implicated.

Scientists have assessed the fertility of male dogs in Britain over the past three decades to find that it’s declined by a whopping 30 percent across five common breeds.

While the researchers aren’t concerned that dogs will lose their ability to reproduce any time soon, they do say the find could have serious implications for human fertility, pointing to the possibility that industrial chemicals in our food packaging could be to blame.

“The dogs who share our homes are exposed to similar contaminants as we are, so the dog is a sentinel for human exposure,” lead researcher Richard G. Lea, from the University of Nottingham in the UK, told The New York Times. 

Back in 1988, Lea and his team decided to monitor changes in dog fertility by analysing a population of service animals at a centre for disabled people in England.

A total of 232 dogs from five different breeds – Labrador retrievers, golden retrievers, curly coat retrievers, border collies and German shepherds – were included in the study, and the fertility has been tested every year up to 2014.

As Jan Hoffman explains for The Times, the benefit of working with these dogs in particular is that, not only do they come from an environment where systematic record-keeping is kept for their health and lineage, but they’re also being raised in one location with uniform conditions.

Each year, a selection of 42 to 97 dogs within the group had their fertility tested via sperm samples, and at different intervals throughout the 26 years, dogs with the poorest sperm quality were removed from the test group.

When the researchers looked at the percentage of sperm with healthy motility – the ability to swim in a straight line – they found that it dropped by 2.4 percent every year between 1988 and 1998.

Once the dogs with the worst sperm were removed from the group, the team found that the sperm motility continued to decline by 1.2 percent every year from 2002 to 2014, with an overall decline of 30 percent across the entire study period.

And there were other problems, too.

“Between 1994 and 2014, they also noticed that the mortality rate of the female puppies, although small, showed a threefold increase,” says Hoffman. “And the incidence of undescended testicles [where testes fail to correctly descend into the scrotum] in male puppies, also small, had a 10-fold increase, to 1 percent from 0.1.”

Lea and his team are yet make any definitive conclusions about the cause, but they did confirm the presence of environmental chemicals called PCBs and phthalates in both the dogs’ semen and in testicles removed by vets during routine desexing procedures.

They also found traces of the chemicals in the food given to the dogs.

Once used in the manufacture of plastics and paints, PCBs were widely banned back in the 1970s and ‘80s, and diethylhexyl phthalate (DEHP) has been noted for its potential health risks. But they have a long half-life, and are virtually impossible for us to avoid completely.

“The scientists cannot determine how the chemicals were introduced into the food supply; these are not additives,” says Hoffman. “But Lea and his colleagues speculate that they could be in the packaging as well as in water that came into contact with any ingredients.”

The most worrying thing here is that more than 60 studies – though controversial – have reported a recent decline in human semen quality, in the 53 years between 1938 and 1991, and, as Tim Radford reports for The Guardian, PCBs and phthalates “are ubiquitous, and have been linked to both fertility issues and birth defects”.

And while the decline in human semen quality is still hotly debated, the recent increases testicular cancer and undescended testicles in human babies are not.

But whether or not harmful environmental chemicals are to blame has yet to be confirmed, and Lea and his colleagues have so far only made a correlation between the two things in dogs – not a causative link.

“If you think about it, we are exposed to a cocktail. Who knows how many chemicals are out there and what they are doing?” Lea told The Guardian.

“What we have been able to do here is just to pull out ones that we know are present, and we have tested those in terms of their effects and it does suggest there is an impact. The next stage – and it is a big next stage – is trying to tease out what else is there and how those chemicals are interacting.”

How can I improve my sperm quality?


Sperm quality has been in decline for many years and scientists have citied smoking, alcohol and various other habits as the reason. However the most recent research in the field by researchers at the Universities of Manchester and Sheffield found that smoking cannabis can have a severe effect on male fertility. Other lifestyle choices such as drinking alcohol and wearing tight briefs were not considered to cause any problems, despite earlier reports that suggested these as the main causes.

1.       Consume Red-coloured food: A report published by Ohio’s Cleveland Clinic, found that consumption of lycopene improved the quality, mobility and volume of sperm dramatically, increasing sperm count by up to 70 per cent. Lycopene is found commonly in red fruits and vegetables such as tomatoes,strawberries, cherries and peppers.

2.      Massage with Herbal oils: Along with regular exercise, massage improves overall blood flow and circulation. Increased circulation means healthier sperm.

3.      Stay away from the Laptop: A 2011 study published in the journal of Fertility and Sterility suggested that there could be a link between using a laptop with a Wi-Fi connection and a reduction in sperm quality. The sperm stored under the laptop became more sluggish and showed signs of DNA damage. (http://www.fertstert.org/article/S0015-0282(11)02678-1/abstract)

4.      Reduce Stress: Stress hormones block Leydig cells, which are tasked with regulating testosterone production. When your body experiences too much stress, it can actually stop producing sperm altogether.

5.      Avoid Cycling: A 2009 spanish study by the Andalusian Center of Sports Medicine and the University of Las Palmas found that a prolonged drive on your bike can severely affect the shape and quality of your spermatozoids. After monitoring 15 Spanish triathletes with an average age of 33 the study found that “those that systematically cycled 300 kilometers a week– had less than 4pc, which is considered a fertility problem”. (http://www.uco.es/uconews/article/cycling-at-a-professional-level-affects-the-quality-of-sperm/) 

6.      Eat Healthy Foods: Eat plenty of fish, meat, eggs, fruits and vegetables. Nuts like peanuts, walnuts, cashews, sunflower and pumpkin seeds are also considered to increase sperm count.

7.      Avoid Soy and High fructose corn-syrup: Soy foods have a mild estrogenic effect on the body and high-fructose corn syrup causes insulin resistance, which lowers fertility. Men who drink a quart of Cokeregularly have 30% less sperm than men who don’t drink Coke.

8.     Avoid Heat: The optimum temperature for sperm production is 34.5 degrees Celsius, which is slightly below body temperature. A three-year University of California study in 2007 found that five out of 11 men who stopped taking hot baths experienced a sperm count rise of almost 500 per cent. (http://news.bbc.co.uk/2/hi/health/6418771.stm) 

9. Consume Supplements:  Try supplements that are made from natural herbal ingredients to specifically help the body make more semen. Research found that men who consumed 5 mg of folic acid and 66 mg of zinc sulfate a day for 26 weeks experienced an almost 75 percent increase in sperm count. Vitamin C and selenium may also be good supplements to take in order to increase sperm production.

10 . Eat Brassica Vegetables: Vegetables such as broccoli, brussels sprouts and cabbage cleanse the liver. They help the liver detoxify, and lowering your toxic load improves sperm health.

11.   Drink Coffee: In 2003, researches from Sao Paolo University in Brazil studied 750 men and concluded that drinking coffee can improve the swimming speed of human sperm, although whether this means pregnancy rates are higher among coffee drinkers is unclear. Some other studies have suggested that drinking just three cups of coffee a day can cause genetic mutations in sperm, making it harder for them to successfully fertilise an egg. (http://www.bupa.co.uk/individuals/health-information/health-news-index/2003/hi-211003-sperm)