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  • Title: [Spermatogenesis protection: myth or reality?].
    Author: Jegou B, Velez De La Calle JF.
    Journal: Contracept Fertil Sex (Paris); 1993 Oct; 21(10):744-8. PubMed ID: 12287596.
    Abstract:
    The male reproductive system is especially sensitive to the deleterious effects of many natural environmental agents, the workplace, and medical agents. Immunosuppressants and anticancer agents, which improve the prognosis of survival or the quality of life of patients, induce temporary sterility in all treated patients and complete sterility in 50% of treated patients. These agents affect spermatogenesis. Quantitative effects include oligo- and azoospermia. Qualitative effects involve spermatozoa changes, which inhibit implantation and their ability to fertilize the ovum and adversely affect embryonic development. Research is and has been underway to identify possible ways to preserve spermatogenesis. The Centers for the Study and Conservation of Human Sperm (CECOS) in France receives sperm every year from many men with cancer, especially Hodgkin's disease or testicular cancer, who wish CECOS to preserve their sperm through cryopreservation before they undergo chemotherapy or radiotherapy. Using less deleterious agents instead of cytotoxic drugs is a possible means to protect spermatogenesis. Agents which have been tested include antioxidants, gonadotropin-releasing hormone analogs, follicle stimulating hormone, and steroids. Of these agents, medroxyprogesterone acetate and testosterone together (MPA + T) have been examined the most in rats (contraception and protection) and in men (contraception). The rat studies show that MPA + T can indeed protect spermatogenesis. Clinical trials in men are needed to support these findings. INSERM supports a multidisciplinary group examining spermatogenesis preservation called Prosperm, which will likely be the impetus for the start-up of such clinical trials. Prosperm members include researchers and physicians who network to keep each other up-to-date on spermatogenesis protection. Their collaboration is especially needed, since recent epidemiological studies indicate that diverse environment factors adversely affect spermatogenesis.
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