Male Infertility And Risk Of Developing Cancer

According to a new study conducted by scientists at Stanford University, male infertility is very strongly linked to an aggravated risk of developing malignancy later in life (1).

This retrospective study was conducted on 2,238 men who visited Baylor College of Medicine in Houston over a period of 20 years (from 1989 to 2009) for the infertility treatment. As part of the investigation process, semen analysis was also performed in addition to other diagnostic and laboratory tests. Scientists discovered that 451 men had azoospermia in which semen sample is completely devoid of viable sperms.

During the study period spanning around 2 decades, research team discovered that 29 patients were diagnosed with a new malignancy (but surprisingly most cases were reported among azoospermic men). It is imperative to mention that researchers excluded the men who had a history of cancer (to eliminate the possibility of azoospermia secondary to the malignant process).

Based on the data obtained, research team suggested that:

• Infertile men are more susceptible to develop cancers.
• Azoospermic men are three-times more likely to get diagnosed with a malignant process.

Situation is even more alarming for men who are under 30 years of age (as susceptibility to develop a cancerous process increases 8-folds in young azoospermic men).

How Can Infertility Lead To Malignancy In Men?

Various studies have linked infertility with cancer of vital organs such as brain, prostate and testicles (and in some cases, with lymphoma and melanoma in men).

The exact pathophysiology is not known but scientists have proposed these hypothesis:

• Defective genes: Scientists believe that inheritance of some defective genes can make a person more vulnerable to infertility and cancers i.e. independent association (2).
• Common etiological factors: Exposure to certain toxins, chemicals or hazardous agents can contribute to the pathogenesis of both conditions simultaneously. For example, according to a new study reported in the Toxicology Letters (3), investigators suggested that individuals who are born with polymorphism of ‘OGG1 Ser326Cys’ are more susceptible to cigarette smoke. In other words, exposure to chronic active smoking can lead to significant oxidative damage of tissue that may culminate in infertility as well as malignancy.
• Fertility treatments and malignancy: Study reported in the Current Medicinal Chemistry (2) suggested that certain fertility treatments can also lead to malignancy. Although, women are more likely to develop cancer in response to fertility drugs, it is believed that male offspring born to such mothers are also more likely to develop azoospemia and malignancy later in life.

Infertility is not just a condition but can also be a harbinger for developing a malignant process. Infertility issues, especially azoospermia in men should be thoroughly investigated to minimize the risk of complications. The Eisenberg study suggested that the risk in short terms (up to 6 years) is 3.5%, but in the long term, the chances of developing a malignancy is much higher in azoospermic men (4). Needless to say that this segment of male population should volunteer for periodic medical examinations to detect the malignant processes early.

References

1. Eisenberg, M. L., Betts, P., Herder, D., Lamb, D. J., & Lipshultz, L. I. (2013). Increased risk of cancer among azoospermic men. Fertility and sterility, 100(3), 681-685.

2. Schaffer, M., Manuela Schaffer, P., Kassem, R., & Ben Shlomo, I. (2016). The Possible Role of Infertility Drugs in Later Malignancy: A Review. Current medicinal chemistry, 23(9), 852-859.

3. Ji, G., Yan, L., Liu, W., Qu, J., & Gu, A. (2013). OGG1 Ser326Cys polymorphism interacts with cigarette smoking to increase oxidative DNA damage in human sperm and the risk of male infertility. Toxicology letters, 218(2), 144-149.

4. Schlegel, P. N. (2013). The relevance of increased cancer risk in infertile men. Fertility and sterility, 100(3), 651.