Sperm preservation by electroejaculation in adolescent cancer patients

Abstract

The increasing prevalence of cancer survivors who are infertile due to gonadal failure highlights the importance of fertility preservation prior to gonadotoxic treatments. Adolescent cancer patients may not be mature enough to produce sperm by masturbation, leading to the use of alternative methods for obtaining sperm for cryopreservation. The aim of the current study was to evaluate the safety and efficacy of electroejaculation (EEJ) for cryopreservation among adolescent cancer patients. This retrospective cohort study included 45 adolescent (12-18 years old) cancer patients who underwent EEJ during 2002-2012 in an academic tertiary referral fertility center. Sperm cryopreservation, ejaculate parameters, and procedure complications were evaluated. EEJ was performed without documented complications. Sperm was successfully obtained in 30 (66.7%) patients. Retrieval failures included ejaculates without sperm in 8 patients (17.8%) and no ejaculate in 7 patients (15.5%). Cryopreserved ejaculates were characterized by severe asthenospermia, normal sperm concentration, and low volume. Retrieved sperm group was further divided to 19 motile sperm ejaculates with significantly higher volume, sperm concentration, and total count compared to 10 non-motile sperm patients. EEJ is a safe and feasible procedure for cryopreservation in adolescent cancer patients who are unable to masturbate. The wide diversity of EEJ outcome and ejaculate parameters may represent a continuum of pubertal changes in that population.