Kanser hastalarında sperm kriyoprezervasyonu: 13 yıllık tecrübe

Abstract

ABSTRACT
 Purpose: The study represents 13 years experience of sperm cryopreservation for different cancer types by researching the semen parameters, the use of frozen-stored samples in ART-ICSI (Assisted Reproductive Technologies-intracytoplasmic sperm injection) cycles, and their current storage status.
 Materials and Methods: Sperm cryopreservation in order to fertility preservation was conducted on 318 patients who had different malignancies applied to the Reproductive Center of Ankara Bilkent City Hospital (from November 2019 to April 2023) and Zekai Tahir Burak Women’s Health Hospital (from January 2010 to September 2019). The age, cancer type, semen volume, sperm count, sperm motility, samples storage status, and usage of banked sperm in ART cycles were recorded and analyzed.
 Results: Sperm cryopreservation was applied to a total of 318 patients for 13 years. The major cancer types of patients are testicular cancer (54.7%), lymphoma (17.3%), and leukemia (10.1%). 11% (n=35) of patients are under the age of 18 years old. The lowest sperm cryopreservation age at 14 years old in four patients. The highest median semen volume was detected in leukemia (3.1 (1.5-6.0)), and the lowest mean semen volume was in the urinary system tumor (1.5 (1.0-2.0)).In testicular cancer, the median(min-max) sperm concentration is 12.5 (1.0-100.0)×106/mL. In lymphoma, the median(min-max) sperm concentration is 40.0 (1.0-140.0)×106/mL. In leukemia, the median(min-max) sperm concentration is 24.5 (1.0-130.0)×106/mL. Sperm concentration significantly decreased in men with testicular cancer. The highest median of sperm motility was observed in nasopharyngeal tumor group (40.0 (20.0-60.0)). Compared to other cancer patients, individuals with leukemia (20.0 (2.0-55.0)) and urinary system tumors (8.0 (6.0-55.0)) showed lower sperm motility. Leukemia (20.0 (2.0-55.0)) The longest time of sexual abstinence was detected in leukemia 7.0 (1.0-25.0) and osteosarcoma (7.0 (3.0-10.0)). Four patients applied to our center to use their frozen sperm. The patients underwent five ART (ICSI) cycles and four embryo transfers. One of the patient had abnormal fertilization and one of the patient had twin clinical pregnancy. Three patients transferred their banked sperm to another center. Sperm samples of 277 patients continue to be stored in our fertility center.
 Conclusion: Since surgical methods, chemotherapy and radiotherapy treatments used for cancer treatment have intense negative effects on spermatogenesis and fertility health, sperm cryopreservation is the gold standard and increasingly being recommended in clinical practice for preserving the fertility potential of cancer patients before treatment.