Analysis of semen parameters in a young cohort of cancer patients

Abstract

Our data support that sperm banking pubertal males prior to the initiation of therapy is feasible. While there were differences in quality of semen parameters across age and diagnostic groups, most males, regardless of age or diagnosis, had adequate specimens for cryopreservation.

Genitourinary cancer patients have worse baseline semen parameters than healthy sperm bankers

“…It has been suggested that as many as two-thirds of cancer patients have impaired fertility at baseline (van Casteren et al, 2010), but studies have reported heterogeneous findings as to whether and how specific types of malignancy are linked to diminished semen parameters (Auger et al, 2016;Caponecchia et al, 2016;Paoli et al, 2016;DiNofia et al, 2017;MacKenna et al, 2017). It has been suggested that as many as two-thirds of cancer patients have impaired fertility at baseline (van Casteren et al, 2010), but studies have reported heterogeneous findings as to whether and how specific types of malignancy are linked to diminished semen parameters (Auger et al, 2016;Caponecchia et al, 2016;Paoli et al, 2016;DiNofia et al, 2017;MacKenna et al, 2017).…”

Fertility preservation options in pediatric and adolescent patients with cancer

“…Electroejaculation must be performed under general anesthesia. 40 Despite this recommendation, an inadequate duration of time between the diagnosis and initiation of therapy often is perceived as a barrier to sperm cryopreservation. 5 In a retrospective cohort study of semen parameters for a large cohort of adolescents and young adults with cancer, approximately 84.0% of patients who provided a semen specimen after the initiation of treatment were azoospermic, compared with only 16.9% in untreated patients.…”

“…40 Despite this recommendation, an inadequate duration of time between the diagnosis and initiation of therapy often is perceived as a barrier to sperm cryopreservation. 38,40,45,46 However, an adequate semen specimen can be obtained in adolescents as young as 11 years of age. Several centers have been successful with sperm cryopreservation in >80% of adolescents and young adults prior to the initiation of therapy.…”

“…[41][42][43] It certainly can be challenging but should be feasible in a majority of patients, regardless of their clinical state at the time of diagnosis. 40 Sperm cryopreservation has been successful in up to 64.5% of adolescents aged 11 to 14 years, with their semen parameters comparing favorably with the World Health Organization reference values for fertile adult men. Studies have emphasized the importance of offering sperm cryopreservation to all adolescents, regardless of their underlying diagnosis or risk of gonadotoxicity with the planned treatment.…”

“…Several centers have been successful with sperm cryopreservation in >80% of adolescents and young adults prior to the initiation of therapy. 40,47 The stage of pubertal development is considered a better predictor of spermarche, although a wide variation in testicular size and the presence of secondary sexual characteristics still can be present at its onset. 40,44 To the best of our knowledge, the age at which to offer sperm cryopreservation is unclear.…”