Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience

Abstract

Background Sperm cryopreservation, an effective method for preserving male fertility, is very advantageous for men suffering from cancer. Unfortunately, as both physicians and cancer patients are unaware of the possibilities for sperm cryopreservation, the data on evaluation of semen parameters and disposition of cryopreserved samples among Chinese cancer patients are scarce. Results Male tumours were classified into six major types, germ cell tumours (26 %), haematological neoplasms (28 %), head and neck cancers (19 %), thoracic tumours (4 %), abdominal tumours (10 %), and others (13 %). Haematological neoplasm was the most prevalent cancer among our cohort of patients who opted for sperm banking, followed by germ cell tumours. Patients with germ cell tumours had the lowest pre-thaw and post-thaw seminal sperm concentrations. We separately compared patients with testicular tumours, lymphoma, and leukaemia, and found that leukaemia patients had the lowest pre-thaw sperm concentrations. Most cancer patients (58 %) chose to keep their specimens stored, while 31 % chose to discard the specimens. Over the years, only 13 patients (4 %) returned to use their spermatozoa by assisted reproductive technology. Of the stored samples, patients with germ cell tumours constituted the highest proportion (29.3 %). Moreover, the percentage of haematological neoplasm patients who had no spermatozoa frozen was the highest (46.2 %). Conclusions The present data confirm the deleterious impact of various cancers on semen quality. Leukaemia was associated with the worst semen quality and the highest number of semen samples that could not be frozen. We suggest that sperm quality may have decreased even before anti-neoplastic treatment and that sperm banking before treatment should be strongly recommended for cancer patients. A sperm banking programme before gonadotoxic therapy requires close cooperation between assisted reproduction centres and cancer clinics.

Fertility preservation in adult male patients with cancer: a systematic review and meta-analysis

“…Sperm quality varies with the type of underlying disease, with patients with testicular malignancy and hematological malignancies showing the lowest sperm counts ( Vomstein et al , 2021 ). However, some studies have not observed differences in sperm parameters among cancer patients ( Auger et al , 2016 ; Song et al , 2019 ; Liu et al , 2021 ). In the present study, failed-to-cryopreserve occurred in 10% (95% CI, 8–12%) of the patients.…”

An evaluation of the population characteristics, semen quality, and utilization status of autologous sperm cryopreservation and fertility preservation in for 662 patients: a 6-year monocentric retrospective study

“…Leukemia had a significant effect on sperm motility-related parameters and RRPM. Previous research demonstrated that a variety of tumors had a significant and negative impact on the quality of semen and the production of sperm in young adult men, and that patients with testicular or hematological tumors had a significantly lower SC or TSC, RRPM, and TPSA; furthermore, the lowest PR percentages were found in patients with leukemia and brain tumors [ 7 , 11 , 21 , 22 , 28 , 29 ]. According to previous findings, 38.3% of tumor patients undergoing autologous sperm preservation had normal semen quality, 7.5% had azoospermia, 57.2% had severe asthenozoospermia, 22.3% had severe oligozoospermia, and patients with TC had the lowest semen parameters [ 30 ].…”

“…Over a follow-up period of 6 to 78 months in our bank, the proportion of subjects who used their preserved semen to undertake ART (in-vitro fertilization/intracytoplasmic sperm injection, IVF/ICSI) was 6.34%. Most previous studies reported that the use of preserved sperm ranged from 3.0% to 11.9% [ 7 , 8 , 15 , 16 , 23 , 28 , 30 , 31 , 33 , 34 ], with a few studies reporting rates as high as 17.2% to 23.2% [ 35 ]. Researchers agree that the use of cryopreserved spermatozoa was low, and that sperm freezing was an important part of the comprehensive suite of treatments for men undergoing gonadotoxic therapy; however, this strategy is under-utilized.…”

Legal relations in the field of human reproductive activity

“…Однак такий природний усталений стан суспільних відносин в умовах глобалізаційних змін піддається трансформації. Зовнішні чинники змінюють буттєві атрибути соціуму, зокрема демографічна криза поєднується з перенаселенням у певних регіонах, медико-технологічні можливості подолання безпліддя не відповідають морально-етичним нормам суспільства, простежується застосування фундаменталістських та новітніх підходів до реалізації права на аборт, клонування людини, кріоконсервації статевих клітин [1], а можливість штучного запліднення потребує оновленого розуміння правового регулювання репродуктивної діяльності людини. Дисонанс проявляється й у відсутності консенсусу між правом на репродукцію і найкращими інтересами дитини, завдяки репродуктивним методикам літній батьківський вік більше не вважається серйозною перешкодою для розмноження, однак значні ризики для здоров'я майбутнього потомства приховані за успіхом репродуктивної медицини для лікування зниженої фертильності, пов'язаної з пізнім батьківством [2].…”