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Reproductive disorders and the ability to preserve the fertility of men with benign and malignant brain tumors
EANS Academy. Astaf'eva L. 09/26/19; 276069; EP13014
Dr. Liudmila Astaf'eva
Dr. Liudmila Astaf'eva

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Abstract
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Brain tumors are on the 3rd place in terms of growth rates of incidence among oncological diseases. By virtue of the improvement of neurosurgical treatment methods, with the use of modern chemotherapy and radiation therapy, the survival of patients with benign and malignant brain tumors is increasing. A significant proportion of patients with such tumors are young people of reproductive age who are interested in maintaining their fertility. Neurosurgical removal of tumors, which are mainly located in the hypothalamic-pituitary region, as well as the applying of chemotherapy and radiation treatment of malignant brain tumors of any localization may be complicated by the development of hypogonadism and infertility. A simple and reliable method of preserving male fertility is currently cryopreservation of sperm. We recommend carrying out a cryopreservation of sperm in young patients, as well as in patients interested in the reproductive potential:
1) in benign tumors of the hypothalamic-pituitary region (invasive, large pituitary adenomas, craniopharyngiomas, etc.):
- with intact gonadotropic function prior to surgery and a high risk of developing hypopituitarism (including hypogonadism);
- with hypogonadotropic hypogonadism after surgical, radiotherapy or drug treatment during the course of gonadotropin therapy.
2) in the case of malignant brain tumors of any localization:
- before radiotherapy and/or chemotherapy
Neurosurgeons, as well as oncologists, radiologists should inform patients with brain tumors about the possible risk of hypogonadism development, infertility and the possibilities of sperm cryopreservation, which increases the chances of having future genetic progeny.
Brain tumors are on the 3rd place in terms of growth rates of incidence among oncological diseases. By virtue of the improvement of neurosurgical treatment methods, with the use of modern chemotherapy and radiation therapy, the survival of patients with benign and malignant brain tumors is increasing. A significant proportion of patients with such tumors are young people of reproductive age who are interested in maintaining their fertility. Neurosurgical removal of tumors, which are mainly located in the hypothalamic-pituitary region, as well as the applying of chemotherapy and radiation treatment of malignant brain tumors of any localization may be complicated by the development of hypogonadism and infertility. A simple and reliable method of preserving male fertility is currently cryopreservation of sperm. We recommend carrying out a cryopreservation of sperm in young patients, as well as in patients interested in the reproductive potential:
1) in benign tumors of the hypothalamic-pituitary region (invasive, large pituitary adenomas, craniopharyngiomas, etc.):
- with intact gonadotropic function prior to surgery and a high risk of developing hypopituitarism (including hypogonadism);
- with hypogonadotropic hypogonadism after surgical, radiotherapy or drug treatment during the course of gonadotropin therapy.
2) in the case of malignant brain tumors of any localization:
- before radiotherapy and/or chemotherapy
Neurosurgeons, as well as oncologists, radiologists should inform patients with brain tumors about the possible risk of hypogonadism development, infertility and the possibilities of sperm cryopreservation, which increases the chances of having future genetic progeny.
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