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Abstract

Volume 15, Issue 3 (May 2013) 15, 382–386; 10.1038/aja.2013.3

Preservation of sperm of cancer patients: extent of use and pregnancy outcome in a tertiary infertility center

Amnon Botchan, Shiri Karpol, Ofer Lehavi, Gedalia Paz, Sandra E Kleiman, Leah Yogev, Haim Yavetz and Ron Hauser

The Institute for the Study of Fertility, Lis Maternity Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6423906, Israel

Correspondence: Dr R Hauser, (ronh@tasmc.health.gov.il)

Received 20 October 2012; Revised 17 December 2012; Accepted 18 January 2013 Advance online publication 25 March 2013

Abstract

Sperm cryopreservation is the best modality to ensure future fertility for males diagnosed with cancer. The extent to which cryopreserved sperm is actually used for impregnation, the fertility treatment options that are available and the success rates of these treatments have not been investigated in depth. The medical records of 682 patients who cryopreserved sperm cells due to cancer treatment were analyzed. Seventy of these patients withdrew their frozen sperm for fertility treatments over a 20-year period (most within the first 4 years after cryopreservation). Sperm quality of different malignancies and outcomes of assisted reproduction treatment (ART) for pregnancy achievement in relation to the type of treatment and the type of malignancy were evaluated. The results showed that the rate of using cryo-thawed sperm from cancer patients for fertility treatments in our unit was 10.3%. Sperm quality indices differed between different types of malignancies, with the poorest quality measured in testicular cancer. Conception was achieved in 46 of the 184 ART cycles (25%), and resulted in 36 deliveries. The use of intracytoplasmic sperm injection (ICSI) methodology yielded a significantly higher pregnancy rate (37.4%) than intrauterine insemination (IUI; 11.5%) and was similar to other groups of infertile couples using these modalities. In vitro fertilization (IVF) failed to produce pregnancies. In conclusion, the rate of use of cryopresseved sperm in cancer patients is relatively low (10.3%). Achievement of pregnancies by ICSI presents the best option but when there are enough stored sperm samples and adequate quality, IUI can be employed. Cryopreservation is nevertheless the best option to preserve future fertility potential and hope for cancer patients.


Keywords: assisted reproduction treatment (ART); cancer; pregnancy outcome; sperm cryopreservation

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.