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Abstract

Volume 23, Issue 5 (September 2021) 23, 490–494; 10.4103/aja.aja_16_21

Sperm banking before gonadotoxic treatment: is it worth the effort?

Kilian Vomstein1, Elisabeth Reiser1, Germar M Pinggera2, Peter Toerzsoek3, Susanne Deininger3, Thomas Kriesche1, Wolfgang Biasio1, Lukas Lusuardi3, Bettina Toth1

1 Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
2 Department of Urology, Medical University Innsbruck, Innsbruck 6020, Austria
3 Department of Urology and Andrology, University Hospital of Salzburg, Salzburg 5020, Austria

Correspondence: Dr. E Reiser (elisabeth.reiser@i-med.ac.at)

Date of Submission 06-Sep-2020 Date of Acceptance 22-Jan-2021 Date of Web Publication 26-Mar-2021

Abstract

We aimed to compare the sperm quality in different cancer types and benign diseases before gonadotoxic treatment, and assess the usage rate of cryopreserved sperm for assisted reproductive treatment (ART). This retrospective study was conducted at two university clinics between January 2008 and July 2018. A total of 545 patients suffering from cancer or benign diseases were included in the study. The pretreatment sperm analyses were based on the World Health Organization (WHO) guidelines. Patients with testicular malignancy (TM) showed a significantly lower sperm count (median [interquartile range]: 18.7 × 106 [5.3 × 106–43.0 × 106] ml−1; P = 0.03) as well as total sperm count (42.4 × 106 [13.3 × 106–108.5 × 106] per ejaculate; P = 0.007) compared to other malignant and benign diseases. In addition, patients with nonseminomatous TM showed the lowest sperm count (14.3 × 106 [6.0 × 106–29.9 × 106] ml−1, vs seminomas: 16.5 × 106 [4.6 × 106–20.3 × 106] ml−1; P = 0.001). With reference to the WHO 2010 guidelines, approximately 48.0% of the patients with TM and 23.0% with hematological malignancies (HM) had oligozoospermia. During the observation period, only 29 patients (5.3%) used their frozen sperms for 48 ART cycles, resulting in 15 clinical pregnancies and 10 live births. The sperm quality varies with the type of underlying disease, with TM and HM patients showing the lowest sperm counts. Due to the observed low usage rate of cryopreserved sperm, further patient interviews and sperm analyses should be included in the routine oncologic protocols to avoid unnecessary storage expenses. However, sperm banking is worth the effort as it provides hope for men who cannot reproduce naturally after gonadotoxic treatment.

Keywords: cryopreservation; fertility; gonadotoxic treatment; sperm count; testicular disease

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