Preservation of sperm of cancer patients： extent of use and pregnancy outcome in a tertiary infertility center

• Published in: Asian journal of andrology 2013-05, Vol.15 (3), p.382-386
• Main Authors: Botchan, Amnon, Karpol, Shiri, Lehavi, Ofer, Paz, Gedalia, Kleiman, Sandra E, Yogev, Leah, Yavetz, Haim, Hauser, Ron
• Format: Article
• Language: English
• Subjects: Cryopreservation; Female; Fertility Preservation; Humans; Infertility, Male - etiology; Lymphoma - complications; Lymphoma - therapy; Male; Neoplasms - complications; Neoplasms - therapy; Original; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Reproductive Techniques, Assisted - utilization; Semen Analysis; Spermatozoa; Tertiary Care Centers; Testicular Neoplasms - complications; Testicular Neoplasms - therapy; 不育; 使用程度; 冷冻保存; 冷冻精子; 妊娠结局; 生育诊断; 癌症患者; 癌症治疗
• ISSN: 1008-682X; 1745-7262
• DOI: 10.1038/aja.2013.3

Sperm cryopreservation is the best modality to ensure future fertility for males diagnosed with cancer. The extent to which cryopreserved sperm is actually used for impregnation, the fertility treatment options that are available and the success rates of these treatments have not been investigated in depth. The medical records of 682 patients who cryopreserved sperm cells due to cancer treatment were analyzed. Seventy of these patients withdrew their frozen sperm for fertility treatments over a 20-year period （most within the first 4 years after cryopreservation）. Sperm quality of different malignancies and outcomes of assisted reproduction treatment （ART） for pregnancy achievement in relation to the type of treatment and the type of malignancy were evaluated. The results showed that the rate of using cryo-thawed sperm from cancer patients for fertility treatments in our unit was 10.3%. Sperm quality indices differed between different types of malignancies, with the poorest quality measured in testicular cancer. Conception was achieved in 46 of the 184 ART cycles （25%）, and resulted in 36 deliveries. The use of intracytoplasmic sperm injection （ICSI） methodology yielded a significantly higher pregnancy rate （37.4%） than intrauterine insemination （IUI; 11.5%） and was similar to other groups of infertile couples using these modalities. In vitro fertilization （IVF） failed to produce pregnancies. In conclusion, the rate of use of cryopresseved sperm in cancer patients is relatively low （10.3%）. Achievement of pregnancies by ICSI presents the best option but when there are enough stored sperm samples and adequate quality, I UI can be employed. Cryopreservation is nevertheless the best option to preserve future fertility potential and hope for cancer patients.