1372 OUTCOMES OF FERTILITY PRESERVATION ATTEMPTS IN PEDIATRIC MALE PATIENTS WITH CANCER

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You have accessJournal of UrologyPediatrics: Andrology - Cryptorchidism & Varicoceles1 Apr 20121372 OUTCOMES OF FERTILITY PRESERVATION ATTEMPTS IN PEDIATRIC MALE PATIENTS WITH CANCER Vidit Sharma, Kunj R. Sheth, Brian Le, Sherwin Zargaroff, James M. Dupree, Barbara A. Lockart, Yasmin C. Gosiengfiao, and Robert Brannigan Vidit SharmaVidit Sharma Chicago, IL More articles by this author , Kunj R. ShethKunj R. Sheth Chicago, IL More articles by this author , Brian LeBrian Le Chicago, IL More articles by this author , Sherwin ZargaroffSherwin Zargaroff Chicago, IL More articles by this author , James M. DupreeJames M. Dupree Chicago, IL More articles by this author , Barbara A. LockartBarbara A. Lockart Chicago, IL More articles by this author , Yasmin C. GosiengfiaoYasmin C. Gosiengfiao Chicago, IL More articles by this author , and Robert BranniganRobert Brannigan Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1756AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES As the long-term consequences of chemotherapy, radiation, and cancer surgery become more apparent, fertility preservation (FP) methods are becoming more available and better utilized by the male pediatric population. The 2006 American Society of Clinical Oncology (ASCO) recommendations call for FP options to be promptly considered in pediatric as well as adult oncology patients. Here we analyze demographics and bulk semen parameters of male pediatric cancer patients pursuing FP. METHODS This IRB-approved, retrospective study included all 13-18 year-old male cancer patients in 2002-2010 who attempted to bank sperm for FP. One patient was excluded for prior radiation treatment. Semen parameters, including ejaculate volume, sperm concentration, total motile sperm count, % motility, and % normal morphology were collected for all patients with comparison across cancer types and patient age. RESULTS Of the 32 male pediatric patients attempting to bank sperm, the mean age was 16.6 years. 30 patients (94%) were able to provide semen samples and 2 patients presented with anejaculation - a 14 yo with osteosarcoma and an 18 yo with lung cancer. Among the 30 other patients, 2 were azoospermic; one underwent TESE to bank sperm, while the other elected not to proceed with further treatments. Leukemia/Lymphoma (19/32) were the most common cancer diagnoses, followed by cancers of the brain (5/32) and soft-tissues (5/32). The semen parameters of our population are summarized in Table 1. No significant difference in bulk semen parameters was seen for the different cancer types. Teenagers 16 to 18 years old showed significantly greater semen volume and % normal morphology than younger patients. Patients attempting to bank sperm prior to chemotherapy (n=20) generally trended towards better semen parameters than those attempting to bank after chemotherapy initiation (n=10); only % motility reached statistical significance. Table 1. Semen parameters in pediatric male cancer patients Patients w/ Semen Analyses Volume (ml) Concentration (106/ml) Motile Sperm (%) Normal Morphology (%) Total Motile Count (106) WHO V reference value 1.5 15 32 4 All Patients (n=32) 30 2.22 23.74 37.06 7.03 33.88 Cancer Type Blood (20) 20 2.19 18.90 33.04 6.49 26.33 Other (12) 10 2.27 33.42 45.10 8.10 48.98 p-value 0.90 0.19 0.26 0.53 0.24 Treatment Before Chemo (21) 19 2.11 29.32 47.36 9.02 40.31 After/During Chemo (11) 11 2.33 18.16 26.77 5.03 27.45 p-value 0.65 0.24 0.04 0.10 0.45 Age 13-15 yrs (8) 7 1.41 17.44 27.14 3.29 17.56 16-18 yrs (24) 23 2.47 25.66 40.08 8.17 38.85 p-value 0.02 0.47 0.32 0.03 0.22 CONCLUSIONS Over 90% of pediatric patients referred for FP were able to successfully bank sperm. Adolescents as young as 13 yrs provided sperm for cryopreservation. Ten patients banked sperm only after initiation of cancer therapy, highlighting the need to define the barriers to prompt sperm cryopreservation in these patients. Older patients showed higher semen volume and % normal morphology when compared to younger patients. Despite the numerous challenges associated with FP in pediatric male cancer patients, sperm cryopreservation was achieved in the vast majority. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e557 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vidit Sharma Chicago, IL More articles by this author Kunj R. Sheth Chicago, IL More articles by this author Brian Le Chicago, IL More articles by this author Sherwin Zargaroff Chicago, IL More articles by this author James M. Dupree Chicago, IL More articles by this author Barbara A. Lockart Chicago, IL More articles by this author Yasmin C. Gosiengfiao Chicago, IL More articles by this author Robert Brannigan Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...