Sperm Cryopreservation: Recent and Marked Increase in Use for Testicular Cancer Compared With Hodgkin Disease

Abstract

In a public network of sperm banks, time trends in use of sperm cryopreservation by men with testicular cancer (TC) and Hodgkin disease (HD) were assessed from 1990 to 2004. During this period, overall incidence of sperm cryopreservation rose from 1.08 to 3.06 per 100 000 person-years for TC and from 0.79 to 1.20 for HD. Modeling suggests that in 2010 the expected rate will reach 5.90 per 100 000 for TC, compared with 1.39 for HD. This increase in sperm cryopreservation for TC and HD is similar to increases observed in incidence of these 2 diseases in France and other European countries. Although TC and HD are rare malignancies, they are the most common cancers in adolescents and young men (Bray et al, 2002). Recent advances in chemotherapy and/or radiotherapy treatments have improved the longterm survival of patients with these diseases (5-year survival rate is approximately 90%). Nevertheless, the side effects of treatment, especially infertility (decrease of 30%), are still a major preoccupation for these young patients who often have not yet fathered children (Huyghe et al, 2004). Accordingly, sperm cryopreservation and sperm banking are now offered to these men before treatment to preserve their capacity to conceive naturally or through assisted reproduction techniques (Hallak et al, 1999; Magelssen et al, 2005). With this aim in mind, a unique public network of sperm banks (Centre d’Etude et de Conservation des Oeufs et du Sperme [CECOS]) was created in France in 1984, and 22 centers now cover the whole country. Sperm banks appear to be increasingly used for sperm donation and to offer the possibility of preserving sperm in the event of disease or surgical treatment, especially for men with HD and TC (Agarwal, 2000). The recent and marked increase of these diseases in most industrialized countries is a major concern (Parkin et al, 1997), drawing the attention of oncologists to the need for sperm cryopreservation. Although this option is still underutilized, it is now becoming a good and safe practice to safeguard future fertility (Chung et al, 2004). The aim of this study was to assess time trends in the use of sperm banking over the period of 1990 to 2004 by men with TC or HD.