Abstract Study question What is the current status of fertility preservation (FP) of male cancer utilization, efficacy and safety in China and what national trends could be observed? Summary answer In this national report on FP status of male cancer over a 11-year period, data on population and trends, region development of FP are analyzed. What is known already Cryopreservation of sperm, the current standard option to preserve male patient's fertility, is very advantageous for men suffering from cancer. Unfortunately, the data on population and trends, region development of fertility preservation (FP)of male cancer in mainland China is scarce. Study design, size, duration A multicenter retrospective study of male cancer patients who performed sperm cryopreservation from 16 regions of a national network of sperm banks over a 11-year period from 2010 to 2020. A total of 2270 men with cancer were referred to 16 human sperm banks for fertility preservation. Participants/materials, setting, methods This national survey was conducted through 16 provincial administrative sectors to sperm cryopreservation for Chinese male cancer. Sperm cryopreservation for male cancer is conducted in 16 human sperm banks, which done well in Sperm cryopreservation for male cancer. Cancer diagnoses were classified according to types, as Testicular tumors, Lymphomas, Leukemia, Colorectal tumors, Nasopharyngeal carcinomas, Sarcomas, Brain tumors, Extragonadal germ cell tumors, and with other cancers grouped together. Main results and the role of chance The number of male cancer patients with sperm cryopreservation showed an overall upward trend. Statistically significant mean yearly increases were observed for three most frequent types of cancer (testicular cancers, lymphoma, leukemia). The development of male cancer FP in the eastern, central, and western regions of Chinese mainland displayed imbalance. There are seven tumor types for sperm preservation in the top incidence ten tumor types, including lymphoma, leukemia, nasopharyngeal carcinoma, sarcoma, thyroid cancer and brain tumor. Moreover, nasopharyngeal carcinoma is a high incidence rate in China, which is related to high sperm preservation rate, different from others countries. The most percentage of males receiving sperm cryopreservation in the testicular cancers (15-39 years old) of China in 2020 was 5.55%, 1.29% in the lymphoma and 0.39% in the Leukemia. According to type of cancer, a statistically significant lower pre-sperm density, total sperm output and post-sperm density was observed in Testicular cancers. It's worth noting that the prevalence of azoospermia 22.2 % in Leukemia patients. Disposition of cryopreserved sperm categories included continued storage (47.2%), discarded (9%), death (0.9%), and use (3.7%). Up to 2020, 70 patients (3.7%) who underwent assisted reproductive technology (ART) used their cryopreserved semen. Limitations, reasons for caution The limitations of our study are the inability to follow-up couples who were naturally conceived. Another limitation is that not all clinical outcomes have been gated. Wider implications of the findings This study provides the most comprehensive national statistical census and review of fertility preservation in men cancer patients trends, quantity and cancer types. Our findings regarding patients’ characteristics and analysis of semen parameters and sperm usage rate. Trial registration number not applicable
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