Sperm Banking For Cancer Patients Research Articles

Fifteen Year Regional Center Experience in Sperm Banking for Cancer Patients: Use and Reproductive Outcomes in Survivors.

Simple SummarySperm cryopreservation before gonadotoxic iatrogenic treatments is the only method currently available to preserve fertility in men with cancer. The aims of this study were to report our 15 years of experience, the clinical outcomes of assisted reproductive treatments as well as neonatal characteristics of babies born. We retrospectively reviewed 682 oncological patients who were referred to our center from 2004 to 2019 for fertility preservation. Data regarding cancer diagnosis, age, and the use of frozen semen were analyzed. The cumulative live-birth delivery rate per couple was 35%. No stillbirths, as well as no malformations in the babies born, were recorded. These successful findings demonstrated that pregnancy could be safely achieved using frozen-thawed sperm of cancer survivors who cryopreserved before gonadotoxic therapies.Cancer treatments frequently impair the reproductive ability of patients by damaging spermatogenesis. International guidelines recommend semen cryopreservation to preserve the fertility of oncological adult males and pubertal boys. However, due to the low usage rate of banked samples, not a lot of data on assisted reproductive treatments (ART) success rates in this population and follow-up data for children born are available in the literature. The aims of this study were to report our 15 years of experience, the clinical outcomes of ART as well as neonatal characteristics of babies born. We retrospectively reviewed 682 oncological patients who were referred to our center from 2004 to 2019 for fertility preservation. Over the years, only 26 patients (4%) returned to use their sperm by ART. They were survivors of leukemia and lymphomas (52%), testicular cancer (20%), and other malignant diseases (28%). These couples performed 45 cycles: 34 intracytoplasmic sperm injection (ICSI) plus 11 frozen embryo transfers. A total of 13 children were born, with 35% of the cumulative live-birth delivery rate per couple. No stillbirths or malformations were recorded. These successful findings demonstrated that pregnancy could be safely achieved using frozen-thawed sperm of cancer survivors who cryopreserved before gonadotoxic therapies.

Sperm Quality is Comparable Among Those Oncological Males Diagnosed Regardless of the Cancer Type

Chemo or radiotherapy treatments can destroy spermatogenic dividing cells and cause azoospermia which could be irreversible. Sperm banking is the best option to preserve male fertility after these treatments. Nevertheless, there could be differences in the sperm quality and clinical status depending on cancer type, and it is important to identify cancer types causing low quality sperm parameters before freezing in order to appropriately inform our patients. Few clinical data are available with large series, hence, we have retrospectively analysed our results of sperm banking for cancer patients in the last thirteen years.

Healthy girl born after cryopreservation of gametes and ICSI in a patient with seminoma

This study reports birth in a case of intracytoplasmic sperm injection with cryopreserved oocytes and spermatozoa banked after radiotherapy and prior to chemotherapy due the occurrence of two non-synchronous seminomas. A 30-year-old male with a diagnosis of seminoma cryopreserved six vials of spermatozoa. After oncological treatment was completed, his partner, a 24-year-old woman, underwent ovarian stimulation. Seventeen oocytes were retrieved; one was at the germinal vesicle stage and two were injected, resulting in two embryos. Fourteen metaphase II oocytes were frozen. The woman presented moderated ovarian hyperstimulation syndrome, and embryo cryopreservation was indicated. After endometrial preparation, two embryos were transferred and a pregnancy was achieved. The woman suffered eclampsia during week 28 of gestation. Caesarean section was performed and a preterm girl weighing 1000 g was born, but died 2 weeks after delivery. A year later, a second procedure was begun. Frozen oocytes and one vial of semen were thawed. Eight of the 14 oocytes survived and were microinjected; two became fertilized and one good quality cleaved embryo was transferred. Pregnancy was achieved and a healthy girl was born with a birth weight of 2800 g. Oocyte cryopreservation associated with sperm banking in cancer patients is a useful tool for couples seeking deferred parenthood.

Practical aspects of sperm banking for cancer patients

Semen storage is now routinely offered to men of reproductive age who are diagnosed with malignant disease and who require surgical or chemotherapeutic treatments that have a significant risk of leaving them sterile or subfertile. There is a perception by the public at large and professionals in the field that this is a routine and simple process. Yet, semen storage for such men requires a number of unique skills from a multidisciplinary team of oncologists, nurses, counsellors and scientists (andrologists or embryologists) in order to provide a quality service to the patient. All too often it is seen as ‘just another branch˚s of assisted conception treatment but there are sufficient unique issues for it to be considered a specialty in its own right. In the absence of professional guidelines to outline ‘best practice˚s, the British Andrology Society invited interested parties to attend a one-day workshop. This was designed as an interactive workshop for all those involved in the process of semen storage, be they clinicians, nurses, counsellors and scientific staff from either the disciplines of reproductive medicine or oncology. It was intended to examine the process of semen storage for such patients from the point of initial diagnosis, through the process of banking semen samples, to the point at which they are either used in treatment or are discarded. The programme was designed to promote maximum interaction between the speakers and the audience and between those from different specialties and disciplines so that they may learn from each other, developing and improving the service that is provided to these men.

Optimum Abstinence Time for Cryopreservation of Semen in Cancer Patients

Although an abstinence period of 48 to 72 hours is the most commonly prescribed interval for diagnostic semen analysis, to our knowledge the association between the abstinence period and sperm quality after cryopreservation has not been identified. Patients with a malignant disease who are consulting for semen banking most often require urgent therapy. Consequently, defining the shortest abstinence period that allows for frequent semen collection within a limited interval and the best post-thaw sperm quality is necessary. We investigated the relationship between abstinence period, and the pre-freeze and post-thaw motility variables in semen specimens obtained from cancer patients for sperm banking. Samples collected from 95 patients were divided according to abstinence period: group 1--15 patients at 24 to less than 48 hours, group 2--53 at 48 to less than 72 hours and group 3--27 at more than 72 hours. Pre-freeze and post-thaw motile sperm count and motion variables (motility, velocity, linearity, amplitude of lateral head movement and motility index), and percentage decrease in sperm variables after cryopreservation were analyzed. Semen volume, the pre-freeze and post-thaw motile sperm count, motion parameters and the percentage decrease in semen variables did not differ significantly among the groups. We conclude that semen collection for cryopreservation after 24 to less than 48 hours of abstinence results in post-thaw quality comparable to that after an abstinence of 48 to less than 72 hours or longer. Thus, an abstinence period of 24 to less than 48 hours can be recommended for sperm banking in cancer patients.