Leukemia and male infertility: past, present, and future

Abstract

Spermatogenesis is the process of the proliferation and differentiation of spermatogonial stem cells (SSCs) to generate sperm. Leukemia patients show impairment in some of the endocrine hormones that are involved in spermatogenesis. They also show a decrease in semen parameters before and after thawing of cryopreserved samples compared to a control. The mechanisms behind these effects have not yet been described. This review summarizes the effect of leukemia on semen parameters from adult patients and highlights feasible suggested mechanisms that may affect impairment of spermatogenesis in these patients. We suggest the possible involvement of leukemia in disturbing hormones involved in spermatogenesis, and the imbalance in testicular paracrine/autocrine factors involved in the formation of SSC niches that control their proliferation and differentiation. Understanding the mechanisms of leukemia in the impairment of spermatogenesis may lead to the development of novel therapeutic strategies mainly for prepubertal boys who do not yet produce sperm.

Keywords:

• Leukemia
• spermatogenesis
• male fertility preservation
• cancer patients
• spermatogonial stem cells
• testis

Aknowledgments

MH is supported by The Kahn Foundation; MH and EL are supported by The United States-Israel Binational Science Foundation; The Natural Science Foundation of China (NSFC) - Israel Science Foundation (ISF) (NSFC-ISF). YM is supported by Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2018.1533126.