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Penile vibratory stimulation and electroejaculation before anticancer therapy in two pubertal boys
M L Schmiegelow1, P Sommer, E Carlsen
1Department of Growth and Reproduction, Juliane Marie Centre, University Hospital, Rigshospitalet, Copenhagen, Denmark.
Journal of Pediatric Hematology/Oncology
|October 27, 1998
Summary
Penile vibratory stimulation (PVS) is a safe and effective method for semen retrieval in pubertal boys undergoing cancer treatment. Electroejaculation (EEJ) is a viable alternative when PVS is unsuccessful.
Area of Science:
- Reproductive medicine
- Pediatric oncology
- Oncofertility
Background:
- Increasing survival rates in childhood cancer necessitate strategies to mitigate long-term side effects like infertility.
- Fertility preservation options are crucial for pubertal boys facing gonadotoxic cancer therapies.
- Advanced reproductive technologies, including sperm cryopreservation and intracytoplasmic sperm injection, enable pregnancy even with compromised sperm quality.
Observation:
- Two adolescent boys with relapsed leukemia and Hodgkin lymphoma underwent semen retrieval prior to chemotherapy and irradiation.
- Penile vibratory stimulation (PVS) was attempted in both patients; it was successful in one and unsuccessful in the other.
- Electroejaculation (EEJ) under general anesthesia was performed in the patient where PVS failed, yielding a retrograde ejaculate.
Findings:
- Patient 1, who underwent EEJ, produced a retrograde ejaculate with 1.6 x 10^6 spermatozoa/ml (5% motility).
- Patient 2, who successfully underwent PVS, produced an antegrade ejaculate of 1.5 ml with 2.5 x 10^6 spermatozoa/ml (29% motility).
- PVS yielded a higher quality and quantity of sperm compared to EEJ in these cases.
Implications:
- PVS is recommended as the primary method for semen retrieval in pubertal boys due to its non-invasive nature and ease of application.
- EEJ should be considered a secondary option, particularly when PVS is unsuccessful or not feasible.
- These findings support the development of fertility preservation protocols for young male cancer patients, enhancing their long-term quality of life.