Androlog

Androlog of the Fertility and Sterility Dialog

Sperm retrieval in advanced prostate cancer patient

Started about 2 years ago

I have a gentleman in his 50s with secondary infertility who was recently diagnosed last July with metastatic (visceral) prostate cancer  who is interested in IVF/ICSI.  I've only had a phone consultation with him, but he's been on docetaxel, bicalutamide, abiraterone, & prednisone. He has erectile dysfunction, doesn't ejaculate, and recently had a TURP,  I was planning on a diagnostic needle TESE, but the patient is very concerned about the potential for genetic defects attributable to the numerous agents he has received thus far for his prostate cancer. Thank you, Ernie Sussman, Las Vegas, NV

That's a really complex problem that has seen the rounds on Androlog before. The general consensus has been that there is no certainty around the time that it would be "safe" for genetic effects on spermatogenesis to subside after chemotherapy, but most feel that 2 years is a reasonable amount of time to wait.