For many people having children is an important aspect of life. Yet as many as 15-20% of all couples struggle to conceive naturally. One of the solutions available for couples is to go through assisted reproduction. It is understandable that healthcare providers and patients only focus on what they consider to be the main aim—to have a baby. However, the struggle to conceive has been shown to be associated with a multitude of future morbidities among men, ranging from metabolic syndrome to autoimmune disease.
In general, men do not undergo any systematic screening or health check-ups, as is common for women from a young age, who have doctor’s appointments for contraceptives or mammographies. These check-ups may well provide an opportunity for women to discuss their health more generally and also help normalise healthcare visits. Many men, on the other hand, tend to avoid healthcare visits altogether, until medical help cannot be ducked any longer. Applying a more long term view, and seeing infertility as an early symptom of general disease, opens up the possibility of offering preventive health measures to a significant proportion of the male population, specifically to those with higher risks for a wide range of disease.
Our new research paper supports this long term view. The study shows that men undergoing assisted reproduction have a large risk increase for prostate cancer. The paper showed that men undergoing intra cytoplasmic sperm injection, the treatment usually reserved for cases of severe male infertility, had the largest risk increase, especially for the early onset variant of prostate cancer. This is particularly important since early onset prostate cancer has long been known to be more aggressive, with corresponding higher mortality rates, and precautionary measures for this disease are rarely adopted before the age of 50 years. That said, the results presented should not cause concern among men undergoing assisted reproduction.
Today, methods for early detection of prostate cancer and effective curative treatment are routinely administered to older men. Younger men, however, are usually not routinely screened. It is noteworthy that assisted reproductive techniques do not, apart from potential psychological stress, have any biological effect on the male patient, as their full involvement is usually only to supply a semen sample. Therefore, we believe that the risk of prostate cancer is inherent to male infertility itself, regardless of fertility treatment type. Consequently, preventative measures may need to be extended from men undergoing assisted reproduction to all men experiencing infertility.
Yahia Al-Jebari, Department of Translational Medicine, Lund University, Malmö, Sweden
Aleksander Giwercman, Department of Translational Medicine, Lund University, Malmö, Sweden and Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
Yvonne Lundberg Giwercman, Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
Competing interests: See research paper