Sperm Cryoconservation before Cancer Treatment:7-year Experience

Overview

Objective:
To compare sperm count of cancer patients with health men, to analyze possible relationof sperm pathology and diagnosis of malignant disease and present experience of our cryopreservationprogramme for cancer patients.Design: Retrospective clinical study.Setting: Department of Obstetrics and Gynecology, Masaryk University, Brno, Czech Republic.Methods: 215 patients (age 25.4 ± 5.6 years) were referred to our unit by oncology specialists forsemen cryopreservation before cancer treatment during 1995–2001. Sperm samples were analysedaccording to guidelines of WHO. Richardson’s medium and Planer Kryo 10 were used forstandard cryopreservation. Sperm count results were compared to control group of 84 men (23.1± 3.6 year) examined as possible sperm donors. Program SPSS version 9 was used for statisticalanalysis. Standard intracytoplasmic sperm injection (ICSI) using frozen spermatozoa was usedfor infertility treatment following malignant disease recovery.Results: Testicular cancer was diagnosed in 115 (53.5 %) patients, malignant disease of lymphaticand haemopoetic tissue in 75 (34.9 %) cases – out of them 35 (16.3 %) Hodgkin’s lymphoma. Twelvemen (5.6 %) were treated for osteosarcoma and 13 for other malignant disease. Only 2.8 % patientshad normospermia. Severe oligospermia < 5 mil/ml was found in 73 men (33.9 %) including 22cases of azoospermia (10.2 %) and 12 cases (5.6 %) of cryptozoospermia. 138 (64.2 %) patients hadasthenospermia < 10 % of progressive motility, 49 (22.8 %) had terratozoospermia < 10 % spermatozoawith standard WHO morphology. Sperm concentration, progressive motility and morphologywere in cancer patients significantly lower (P < 0.001) than in control group. Men with testicularcancer had significantly higher frequency of severe sperm pathology. Only 4 patients have returnedfor assisted reproduction treatment. In all cases ICSI was used, 1 pregnancy and delivery wasachieved. During more than 4 years after cryopreservation died 16.6 % of patients.Conclusion: Cancer patients has significantly higher frequency of severe sperm pathologies thanhealthy men. The most severe sperm pathologies are among men with testicular cancer. Onlyminority of patients return for fertility treatment. Cryopreserved spermatozoa of cancer patientsare able to initiate pregnancy by assisted reproduction techniques.

Key words:
cancer, semen cryopreservation, chemotherapy, male infertility, assisted reproductivetechniques