Cryopreservation of sperm before gonadotoxic treatment at the University Hospital Brno in the years 1995–2020

Authors: Ventruba Pavel 1;  Žáková Jana 1;  Ješeta Michal 1;  Crha Igor 1,2;  Lousová Eva 1;  Huser Martin 1;  Hudeček Robert 1
Authors‘ workplace: Gynekologicko-porodnická klinika LF MU a FN Brno 1;  Katedra ošetřovatelství a porodní asistence, LF MU Brno 2
Published in: Ceska Gynekol 2021; 86(3): 156-162
doi: 10.48095/cccg2021156


Objective: Sperm cryopreservation before gonadotoxic treatment is the basic and mos teffective method of preserving reproduction, which can be used during adolescence. The communication summarizes 26 years of experience in the operation of an oncological sperm bank, analyzes spermiograms of oncological patients, assesses the relationship between sperm pathology and diagnosis, and determines the number of deaths and the use of frozen sperm.

Methods: During the existence of CAR 01 (assisted reproduction center), more than 50,000 spermiograms were performed. From January 1995 to December 2020, a total of 24,729 men were examined within the sperm bank, of which 1,448 (5.9%) had an oncological diagnosis. The spermiograms were evaluated according to current WHO (World Health Organization) manuals. Cryopreservation of sperm has undergone a major development. The rules for the storage of frozen cells have been laid down by Act No. 296/2008 Coll. since 2008. In 2019, the methodology „Cryopreservation of reproductive cells and tissues in patients before cancer treatment“ was updated. In all cases, the standard thawing technique was used. The sperms were processed by the swim-up method. As part of the treatment with assisted reproduction methods, oocytes were fertilized by the ICSI (intracytoplasmatic sperm injection) micromanipulation technique.

Results: Out of 1,448 examined spermiograms in men with oncological diagnoses, testicular cancer was present in 43.7% of patients and malignant diseases of lymphatic and hematopoietic tissue were found in 24.1%, of which 70,1% included Hodgkin‘s lymphomas and 29,9% were non-Hodgkin‘s lymphomas. Leukemia was found in 7.9%, bone and cartilage cancers in 6.8%. The age of the clients of the whole group ranged from 13 to 64 years (27.2 ± 6.8 years). A total of 38.3% of men had normozoospermia, 54.2% of spermiograms showed pathological findings in 1 to 3 evaluated parameters and 7.5% of patients had azoospermia. Severe asthenozoospermia (mobility ≤ 10%) was detected in 57.2% of men and severe oligozoospermia (concentration ≤ 1 × 106 mm3) in 22.3% of patients. The lowest values of the spermiogram were found in men with testicular cancer; the best values were seen in CNS (central nervous system) cancers. The cryopreservation of sperm was performed in 1,340 cases (92.5%). So far, a total of 160 men (11.9%) have used frozen sperm, of which 6.2% in our center. In these 83 cases, the ICSI technique was always used, 38 clinical pregnancies (45.8%) and 32 births were achieved. We have registered 424 completed storages of semen (31.6%), of which 148 (11.0% of all oncology patients) were made due to death and the others at patients’ request. Using the sperm of the dead is a specific issue.

Conclusion: In cancer patients, sperm pathologies occur in high percentage. The lowest spermiogram values were found in men with testicular cancer. It is necessary to take into account long-term storage and fertilization by micromanipulation methods. The number of men who die is significantly higher than the number of those who use sperm to treat infertility. Cryopreservation of sperm should be offered to each patient prior to the therapy leading to the destruction of spermatogenesis.


spermiogram – sperm banking – cryopreservation of sperm – malignancies – gonadotoxic treatment – assisted reproduction – oncofertility – spermiogram – sperm banking – cryopreservation of sperm – malignancies – gonadotoxic treatment – assisted reproduction – oncofertility


1. Crha I, Ventruba P, Petrenko M et al. Kryokonzervace spermatu před onkologickou léčbou – 7 let zkušeností. Ceska Gynekol 2002; 67 (6): 324–328.

2. Ventruba P, Crha I, Žáková J et al. 25 let kryokonzervace spermatu před gonadotoxickou léčbou: 1995–2020. In: Sborník abstrakt 30. sympozia asistované reprodukce SAR ČGPS ČLS JEP a 19. česko-slovenské konference reprodukční gynekologie, 10.–11. 11. 2020. Brno: 16–17.

3. Žáková J, Lousová E, Ventruba P et al. Sperm cryopreservation before testicular cancer treatment and its subsequent utilization for the treatment of infertility. Sci World J 2014; 2014: 575978. doi: 10.1155/2014/575978.

4. Meseguer M, Molina N, García-Velasco JA et al. Sperm cryopreservation in oncological patients: a 14-year follow-up study. Fertil Steril 2006; 85 (3): 640–645. doi: 10.1016/j.fertnstert.2005.08. 022.

5. Tomlinson M, Meadows J, Kohut T et al. Review and follow-up of patients using a regional sperm cryopreservation service: ensuring that resources are targeted to those patients most in need. Andrology 2015; 3 (4): 709–716. doi: 10.1111/andr.12045.

6. Tournaye H, Goossens E, Verheyen G et al. Preserving the reproductive potential of men and boys with cancer: current concepts and future prospects. Hum Reprod Update 2004; 10 (6): 525–532. doi: 10.1093/humupd/dmh038.

7. Nangia AK, Krieg SA, Kim SS. Clinical guidelines for sperm cryopreservation in cancer patients. Fertil Steril 2013; 100 (5): 1203–1209. doi: 10.1016/j.fertnstert.2013.08.054.

8. Vakalopoulos I, Dimou P, Anagnostou I et al. Impact of cancer and cancer treatment on male fertility. Hormones (Athens) 2015; 14 (4): 579–589. doi: 10.14310/horm.2002.1620.

9. Vyhláška č. 422/2008 Sb. O stanovení bližších požadavků pro zajištění jakosti a bezpečnosti lidských tkání a buněk určených k použití u člověka. 2008 [online]. Dostupné z: https: //

10. Xiaohua L, Jiabao W, Yunge T. Effect of tumor and its treatment on fertility of male patients and genetic risk analysis. Chin J Fam Plan 2018; 26: 415–419.

11. Metodický pokyn GPK č. A-3: Kryokonzervace reprodukčních buněk a tkání u pacientů před onkologickou léčbou. 2021 [online]. Dostupné z: http: //

12. Crha I, Ventruba P, Žáková J et al. Survival and infertility treatment in male cancer patients after sperm banking. Fertil Steril 2009; 91 (6): 2344–2348. doi: 10.1016/j.fertnstert.2008.03. 053.

13. Levine H, Jørgensen N, Martino-Andrade A et al. Temporal trends in sperm count: a systematic review and meta-regression analysis. Hum Reprod Update 2017; 23 (6): 646–659. doi: 10.1093/humupd/dmx022.

14. Bolten M, Weissbach L, Kaden R. Cryopreserved human sperm deposits: usability after decades of storage. Urologe A 2005; 44 (8): 904–908. doi: 10.1007/s00120-005-0840-6.

15. Loren AW, Mangu PB, Beck LN et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2013; 31 (19): 2500–2510. doi: 10.1200/JCO.2013.49.2678.

16. Foresta C, Bettella A, Marin P et al. Analysis of sperm aneuploidy in infertile subjects after chemotherapy treatment. Ann Ital Med Int 2000; 15 (3): 189–194.

17. Schrader M, Müller M, Straub B et al. The impact of chemotherapy on male fertility: a survey of the bio­logic basis and clinical aspects. Reprod Toxicol 2001; 15 (6): 611–617. doi: 10.1016/s0890-6238 (01) 00182-4.

18. Huyghe E, Matsuda T, Daudin M et al. Fertility after testicular cancer treatments: results of a large multicenter study. Cancer 2004; 100 (4): 732–737. doi: 10.1002/cncr.11950.

19. Zákon č. 296/2008 Sb. O lidských tkáních a buňkách. 2008 [online]. Dostupné z: https: //

20. Stigliani S, Massarotti C, De Leo C et al. Fifteen year regional center experience in sperm banking for cancer patients: use and reproductive outcomes in survivors. Cancers (Basel) 2021; 13 (1): 116. doi: 10.3390/cancers13010116.

21. Kobayashi H, Tamura K, Tai T et al. Semen cryopreservation as an oncofertility treatment in 122 Japanese men with cancer: a decade-long study. Reprod Med Biol 2017; 16 (4): 320–324. doi: 10.1002/rmb2.12044.

22. van Casteren NJ, van Santbrink EJ, van Inzen W et al. Use rate and assisted reproduction technologies outcome of cryopreserved semen from 629 cancer patients. Fertil Steril 2008; 90 (6): 2245–2250. doi: 10.1016/j.fertnstert.2007.10.055.

23. Ferrari S, Paffoni A, Filippi F et al. Sperm cryopreservation and reproductive outcome in male cancer patients: a systematic review. Reprod Biomed Online 2016; 33 (1): 29–38. doi: 10.1016/j.rbmo.2016.04.002.

24. Huser M, Zakova J, Smardova L et al. Combination of fertility preservation strategies in young women with recently dia­gnosed cancer. Eur J Gynaecol Oncol 2012; 33 (1): 42–50.

25. Ješeta M, Žáková J, Ventruba P et al. Cryopreservation of human gametes and embryos: current state and future perspectives. In: Marco-Jiménez F, Akdemir H. Cryopreservation in Eukaryotes. InTech – Open Acces Publisher. 2016 [online]. Available from: https: //

26. Crha I, Huser M, Žáková J. Onkofertilita – perspektivy a komplikace. Onkologie 2018, 12 (1): 25–28. doi: 10.36290/xon.2018.006.

27. Ventruba P, Žáková J, Crha I et al. Treatment of infertility with cryopreserved sperm before treatment of testicular cancer. In: Conference Abstract Book 3rd International Congress of Gynaecology and Obstetrics, October 24–26. Taiyuan, China, 2014: 63.

28. Huser M, Smardova L, Janku P et al. Fertility status of Hodgkin lymphoma patients treated with chemotherapy and adjuvant gonadotropin-releasing hormone analogues. J Assist Reprod Genet 2015; 32 (8): 1187–1193. doi: 10.1007/s10815-015-0452-z.

29. Huser M, Crha I, Zakova J et al. Fertility preservation in clinical practice. Praha: Maxdorf 2019.

30. Zákon č. 373/2011 Sb. O specifických zdravotních službách. 2011 [online]. Dostupné z: https: //

31. Vyhláška č. 297/2012 Sb. O Listu o prohlídce zemřelého. 2012 [online]. Dostupné z: https: //

32. Crha I, Dostál J, Ventruba P et al. Etické a legislativní otázky odběru a užití spermií zemřelého. Ceska Gynekol 2004; 69 (4): 335–339.

33. Crha I, Ventruba P, Žáková J et al. Kryokonzervace spermatu před gonadotoxickou léčbou – 11 let zkušeností. Ceska Gynekol 2007; 72 (5): 320–326.

34. Ventruba P, Žáková J, Rumpík D. 30. sympozium asistované reprodukce s mezinárodní účastí a 19. česko-slovenská konference reprodukční medicíny, 10.–11. listopadu 2020, Brno. Ceska Gynekol 2021; 86 (1): 61–62.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account