PD05-01 MICRODISSECTION TESTICULAR SPERM EXTRACTION IN PATIENTS WITH AZOOSPERMIA DUE TO CHEMOTHERAPY

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You have accessJournal of UrologyInfertility: Therapy I1 Apr 2016PD05-01 MICRODISSECTION TESTICULAR SPERM EXTRACTION IN PATIENTS WITH AZOOSPERMIA DUE TO CHEMOTHERAPY Takeshi Shin, Yukihito Shimomura, Tomohiro Kobayashi, Akane Miyata, Yoshitomo Kobori, and Hiroshi Okada Takeshi ShinTakeshi Shin More articles by this author , Yukihito ShimomuraYukihito Shimomura More articles by this author , Tomohiro KobayashiTomohiro Kobayashi More articles by this author , Akane MiyataAkane Miyata More articles by this author , Yoshitomo KoboriYoshitomo Kobori More articles by this author , and Hiroshi OkadaHiroshi Okada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2608AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The recent advances in cancer therapies for males of pediatric, adolescent, and reproductive ages over the last several decades have led to increases in long-term survival, making post-treatment quality of life increasingly important. Combinations of surgery, radiation therapy, and chemotherapy may achieve high remission rates in patients with cancer, but the treatment can be harmful to male fertility. Cytotoxic chemotherapy may lead to irreversible spermatogenic dysfunction. Microdissection testicular sperm extraction (Micro-TESE) is the only method for fertility revival in chemotherapy induced azoospermic patients. The aim of this study is to investigate the sperm retrieval rate (SRR) and pregnancy outcome in patients with azoospermia due to chemotherapy undergoing microdissection testicular sperm extraction and to analyze the predictive values of successful sperm retrieval. METHODS A total of 66 azoospermic patients with history of chemotherapy who underwent micro-TESE for sperm retrieval were included in this analysis. We investigated SRR and pregnancy outcome from our medical records and telephone survey. Data on the age, testicular volume, serum follicle stimulating hormone (FSH) level, cancer type and the interval from chemotherapy were also obtained and analyzed to detect any associations with the success in sperm retrieval. RESULTS In a cohort of 66 patients, sperm were successfully retrieved in 31 patients, with clinical pregnancy occurring in 23 couples. Therefore, per-patient SRR was 47% and per-patient pregnancy rate was 35%. Per-patient live birth rate was 27%. Our patients had received chemotherapy for testicular cancer (21 patients), Hodgkin lymphoma (9 patients), non-Hodgkin lymphoma (7 patients), acute lymphoblastic leukemia (9 patients), acute myeloblastic leukemia (7 patients), rhabdomyosarcoma (7 patients), bladder cancer (3 patients), osteosarcoma (2 patients), and anaplastic anemia (1 patient). Table shows detailed information. A multivariate analysis showed no significant predictors of micro-TESE outcome. CONCLUSIONS Micro-TESE is the only method for fertility revival in chemotherapy induced permanent azoospermic patients. However, our results suggest micro-TESE and following intracytoplasmic sperm injection could rescue only 27% of patients with azoospermia due to chemotherapy. No predictive values of sperm retrieval were determined in this analysis. Sperm banking should be offered before any chemotherapy even if the possibility of permanent azoospermia is thought to be low. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e169 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Takeshi Shin More articles by this author Yukihito Shimomura More articles by this author Tomohiro Kobayashi More articles by this author Akane Miyata More articles by this author Yoshitomo Kobori More articles by this author Hiroshi Okada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...