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Sperm cryopreservation in oncological patients: a 14-year follow-up study
Marcos Meseguer1, Nancy Molina, Juan A García-Velasco
1Instituto Universitario Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain. marcos.meseguer@ivi.es
Objective:
Oncologic 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. It is easy, inexpensive, and safe. To date, few clinical data are available about large series of cancer patients. Our objective was to determine the usefulness of these preventive sperm freezing protocols.
Design:
Prospective study.
Setting:
University-affiliated private fertility center.
Patient(S):
One hundred eighty-six cancer patients who banked sperm samples at our center before surgery or chemo- or radiotherapy treatments from 1991 to 2004.
Intervention(S):
Conjugal status, age, type of cancer, treatment, and future use (if any) of the cryopreserved sperm samples for assisted reproduction technology (ART), and cycle results were recorded, analyzed, and compared with a control group.
Main Outcome Measure(S):
Basic sperm analysis of semen samples from cancer patients prior to freezing, after thawing, and after capacitation for ART.
Result(S):
A total of 320 semen samples were frozen before antineoplasic treatment. Six months later, 27% of the males recovered normal sperm production. From all frozen samples, 8.7% were discarded; the reasons were pregnancy achievement (55%), normal sperm production (28%), and patient death (18%). Finally, 5 IUI cycles and 30 ICSI cycles were done from frozen samples, with 1 and 15 pregnancies, respectively; results were comparable with those obtained in a control group.
Conclusion(S):
A significant number of males who cryopreserved semen samples before receiving antitumoral treatments have employed them. The results obtained showed that this is the strategy of choice, aiming to preserve fertility for the future, because the cost/benefit ratio is favorable. Patients should be counseled accordingly.
Insights
Sperm banking before cancer treatment is a viable fertility preservation method. Many cancer patients successfully use cryopreserved sperm for assisted reproduction, achieving pregnancies with favorable cost-benefit outcomes.
Area of Science:
- Reproductive Medicine
- Oncology
- Cryobiology
Background:
- Cancer treatments like chemotherapy and radiotherapy can cause irreversible azoospermia.
- Sperm banking offers a safe, effective, and accessible fertility preservation option for male cancer patients.
- Limited clinical data exist on large cohorts of cancer patients undergoing sperm cryopreservation.
Purpose of the Study:
- To evaluate the clinical utility and success rates of sperm cryopreservation protocols in male cancer patients.
- To determine the long-term effectiveness of frozen sperm samples for assisted reproduction.
- To assess the cost-benefit ratio of fertility preservation in oncology.
Main Methods:
- Prospective study conducted at a university-affiliated fertility center.
- 186 cancer patients underwent sperm banking between 1991 and 2004 prior to oncologic treatments.
- Analysis included patient demographics, cancer type, treatment, sperm analysis before and after thawing, and assisted reproduction technology (ART) outcomes.
Main Results:
- 320 semen samples were cryopreserved; 8.7% were discarded due to successful pregnancies or recovered sperm production.
- 27% of patients regained normal sperm production within six months post-treatment.
- ART cycles using frozen samples resulted in pregnancies (1 IUI, 15 ICSI), comparable to control groups.
Conclusions:
- Sperm cryopreservation is a highly effective fertility preservation strategy for male cancer patients.
- A significant proportion of patients utilize their cryopreserved samples for achieving future pregnancies.
- The favorable cost-benefit ratio supports sperm banking as the primary fertility preservation method in oncology.
