Sperm banking and assisted reproduction treatment for couples following cancer treatment of the male partner

Abstract

In recent years, the survival of young males suffering from cancer has been improved. Development of new techniques such as IVF and intracytoplasmic sperm injection enables even low quality spermatozoa to be used successfully. It is possible therefore to preserve fertility potential of cancer patients before embarking on adjuvant chemotherapy and radiotherapy. Recognizing the importance of protecting the fertility potential of these young males, we present our recommendations for sperm cryopreservation based on the 11 year experience of Bourn Hall and the British Joint Council for Clinical Oncology consultation report. This paper discusses the options available for patients who recover from cancer to become fathers. In many cases patients are concerned about possible abnormalities and teratogenic risks to their future children who have been conceived naturally or by fertility treatment. The data available in the literature may reassure the medical community that there is no such increased risk. However, due to the relatively small number of children born after such treatment, a long-term follow-up is required. There is an ongoing debate regarding the justification for the programme due to the small number of patients who make use of their banked spermatozoa. The authors believe in the importance of protecting the fertility potential of cancer patients, enabling them to father their genetic children in the future while fighting their illness.

Sperm banking for male cancer patients: social and semen profiles

“…The decision to offer each technique is based on the semen quality pre-freeze and postthaw. Where adequate amounts of spermatozoa have been banked and semen quality allows, intra-uterine insemination using the thawed spermatozoa could be considered, and in vitro fertilization (IVF) techniques including ICSI are generally recommended where the quantity of sperm available is small or as deemed necessary per female pathology (18).…”

“…The lack of sperm banking that was offered may be explained by several reasons: recovery or waiting for possible recovery of gonadal function, short period from original illness, anxiety regarding potential risks for the children and uncertainty about their long-term health and therefore their suitability to be parents (18).…”

Effects of oncological treatments on semen quality in patients with testicular neoplasia or lymphoproliferative disorders

“…In several countries, sperm cryopreservation before gonadotoxic therapy is a common practice for the preservation of reproductive potential in cancer treatment survivors, and specific procedures are well established. [11][12][13] The aim of this study was to evaluate the effects of chemotherapy and radiotherapy on seminal and reproductive hormones parameters in patients with malignant testicular tumors or lymphoproliferative disorders.…”

Sperm DNA fragmentation in cryopreserved samples from subjects with different cancers

“…The findings of the present study may contribute to explaining the lower pregnancy rate when cryopreserved semen from cancer patients is used in IVF cycles (Kelleher et al 2001;Lass et al 2001;Ragni et al 2003;Agarwal et al 2004;Chung et al 2004;van Casteren et al 2008). Studies in animals and men demonstrate that DNA-fragmented spermatozoa can fertilise an oocyte and produce viable embryos (Ahmadi and Ng 1999;Fatehi et al 2006;Pérez-Cerezales et al 2010;Yamauchi et al 2012).…”