Sperm Banking before Gonadotoxic Treatment – 11-years Experience
I. Crha 1; P. Ventruba 1; J. Žáková 1; B. Kubešová 2; J. Jarkovský 3; M. Huser 1
Gynekologicko–porodnická klinika Masarykovy univerzity a FN Brno
přednosta prof. MUDr. P. Ventruba, DrSc.
1; Tkáňová banka FN Brno, přednostka prim. MUDr. B. Kubešová
2; Institut biostatistiky a analýz Masarykovy univerzity, přednosta doc. RNDr. L. Dušek, PhD.
Čes. Gynek.2007, 72, č. 5 s. 320-326
The aim of this study was to analyze possible relation of sperm pathology and diagnosis of malignant disease and present our experience of sperm banking programme for cancer patients.
Retrospective clinical study.
Department of Obstetrics and Gynecology, Masaryk University, Brno.
Material and methods:
521 patients (age 26.0±6.7 years) were referred to our unit by oncology specialists for semen cryopreservation before cancer treatment during 1995–2005. Sperm samples obtained by masturbation were analysed according to guidelines of WHO. Cryoprotective medium and Planer Kryo F 10 were used for standard cryopreservation. National cancer register was used to analyze patients survival. Basic statistics was used for data description and relations among sperm parameters and diagnosis were tested by Kruskal-Wallis ANOVA. Standard intracytoplasmic sperm injection (ICSI) using frozen spermatozoa was used for infertility treatment following malignant disease recovery.
Testicular cancer was diagnosed in 45.7% patients, malignant disease of lymphatic and haemopoetic tissue in 32.0% cases – out of them 16.5% Hodgkinęs lymphoma. Sperm concentration ≥ 20 mil/ml had 45.9% men. Severe oligospermia ≤ 1 mil/ml was found in 23.2% men and azoospermia in 10.0% patients. Severe asthenospermia ≤10% was in 60,8% men. Sperms were retrieved in 76.7% of 30 boys 14 to 16 years old, in 46.7% was concentration lower than 1 mil/ml and in 26.1% sperm motility lower than 1%. Sperm concentration was significantly lower in men with testicular cancer (p = 0.002), differences in sperm motility were insignificant. Cryopreserved samples were used in 30 patients (5.8%), 22 of them in our centre. Intracytoplasmatic sperm injection was used in all cases, 7 clinical pregnancies (31.8%) and 5 deliveries were achieved. In the group of all patients died 62 men (11.9%).
Cancer patients have high frequency of severe sperm pathology. The lowest sperm concentration was in men with testicular cancer. Only minority of patients return for fertility treatment. Cryopreserved spermatozoa of cancer patients are able to achieve pregnancy by assisted reproduction techniques.
cancer, semen cryopreservation, chemotherapy, male infertility, assisted reproduction techniques
Gynaecology and obstetrics