Fertility maintenance in male oncological patients: current state and future perspectives.

Growing cancer incidence in reproductive age goes hand in hand with a rising survival rate of patients who underwent anticancer therapy. This trend points to the necessity of discussion regarding the fertility maintenance. The patient´s future with respect to his reproductive ability has to be addressed properly to achieve a complex approach to cancer management. The germinal epithelium of the testes is highly susceptible to deleterious effects of chemotherapy. After the administration of gonadotoxic chemotherapeutic agents, a patient can develop oligospermia, or even azoospermia. Similarly, radiation exposure can damage spermatogenesis, while higher doses lead to azoospermia. This review brings an overview of the methods of assisted reproduction, which are currently in use for fertility maintenance in oncological patients, but also in those with non-malignant indications. Also, novel, yet still experimental, methods are discussed, which represent promising technologies applicable to prepubertal oncological patients. We also discuss historical milestones in the development of assisted reproduction, summarize the options of semen analysis, and we present a practical guide through the process of sperm cryopreservation and subsequent in vivo or in vitro fertilisation. We deem that fertility maintenance should be an integral part of the health care in oncological patients in reproductive age (Tab. 1, Ref. 85). Keywords: assisted reproduction technique, sperm cryopreservation, testicular tissue cryopreservation, spermatogenesis, sperm quality in oncological patients.

Sex-specific response of renal Na,K-ATPase to prenatal angiotensin 2 exposure and increased salt intake in offspring.

In rodents, increased angiotensin 2 (Ang2) during pregnancy increases blood pressure and decreases salt sensitivity in the offspring. To explore the underlying mechanisms, this study evaluated the effects of prenatal Ang2 exposure on the activity of renal Na,K-ATPase, which is one of the main systems that maintains sodium ion homeostasis in an organism. Moreover, this study also investigated the impact of a higher-salt diet on the enzyme activity in the offspring in a sex-dependent manner. Pregnant Wistar rats were implanted with osmotic minipumps that continuously released Ang2 (2 µg/kg/h) for 2 weeks. Male and female offspring of treated and control females were allocated to groups fed with normal or high-salt diets. In the offspring prenatally treated with Ang2, a significant Vmax increase (23 - 36%) was observed in females fed with both a normal and high-salt diet. In addition, a significant increase in Km (20 - 26%) was also observed in the female groups, compared to respective male groups, independently of their diet. Evaluation of KNa showed significantly lower values (13 - 17%) in female offspring fed with a high-salt diet, independent of the prenatal treatment. In conclusion, these data suggest that increased prenatal Ang2 has a predominant impact on the properties of renal Na,K-ATPase in both sexes. Moreover, the enzyme is resistant to higher salt intake in offspring prenatally exposed to Ang2.

Different effects of phase advance and delay in rotating light-dark regimens on clock and natriuretic peptide gene expression in the rat heart.

Under physiological conditions the mammalian circadian system is synchronized to a cyclic environment. The central oscillator in the suprachiasmatic nuclei (SCN) responds predominantly to an external light (L) dark (D) cycle. Peripheral oscillators are more efficiently synchronized by metabolic cues. When the circadian system is exposed to opposing synchronizing cues, peripheral oscillators uncouple from the SCN. To consider influence of phase advances and delays in light regimens mimicking shift work, we analyzed the expression of clock genes (per2, bmal1) and natriuretic peptides (anp, bnp) in the heart of male rats. Experimental groups were exposed to a rotating LD regimen with either 8 h phase advance or delay for 11 weeks. Samples were taken for a 24 h cycle in 4 h intervals. Peripheral oscillators responded to rotating phase advance by decreasing rhythm robustness, while phase delay mostly influenced the phase angle between the acrophase of rhythmic gene expression and the external LD cycle. The expression of anp was arrhythmic in the heart of control rats and was not influenced by rotating LD regimens. The expression of bnp showed a daily rhythm with a nadir during the active phase. The daily rhythm in bnp expression diminished under rotating LD regimen conditions.