Malignant Conditions

Testicular and systemic malignant conditions have been proven to result in male infertility even before the initiation of cancer treatments [93]. Patients with testicu-lar and systemic malignancies present with higher levels of DNA fragmentation compared to fertile controls [86] . The levels of DNA fragmentation appear to be more significant in patients diagnosed with Hodgkin's and non-Hodgkin's diseases [94]. In addition, management of malignant conditions including chemo and radiotherapy has a negative impact on male fertility. The different therapeutic agents used for cancer treatment result in sperm DNA damage, which may present with mutations, repeated miscarriages, and carcinogenesis in offspring [95].

The structural organization of sperm DNA is vital for the proper functioning of the spermatozoa [96]. It is not clear whether the cancer itself is capable of inducing changes in the genomic integrity of the spermatozoa. If the DNA is structurally intact, such patients can enroll in sperm banking and have increased success when using assisted reproductive procedures such as ICSI.

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