Preserving sperm before cancer therapy can enhance the likelihood of later fatherhood.
As survival rates after cancer rise, more emphasis has been placed on preserving fertility despite probable chemotherapy- and radiation-induced sterility in both men and women. Does cryopreservation of sperm before treatment allow men who survive cancer to father children later? To address this issue, researchers evaluated data from all 118 couples who underwent in vitro fertilization (IVF) procedures with pretreatment cryopreserved sperm during a 12-year period at a single center in New York City.
Before cancer treatment, about 43% of men had at least one abnormal parameter in their semen analyses, and about 20% had very-low total sperm counts (<5 million/mL). Prostate and testicular malignancies were most likely to affect semen parameters adversely. After cancer treatment, 72 men were evaluated for sperm quality, and fully 78% of them were azoospermic. Although sperm was frozen for an average of 7 years, 96 pregnancies and 85 deliveries (of 126 children) resulted from intracytoplasmic sperm injection. At time of IVF, the average age of the women was about 35.
Comment: Data on the health of the children born to this cohort are still limited, but no evidence has accrued to date for excess genetic abnormalities. Although we must remain cautious, these findings emphasize the need to discuss future fatherhood with young men who have malignancies and to encourage cryopreservation of sperm before cancer treatments.
— Robert W. Rebar, MD
Published in Journal Watch General Medicine October 23, 2008
Hourvitz A et al. Intracytoplasmic sperm injection (ICSI) using cryopreserved sperm from men with malignant neoplasm yields high pregnancy rates. Fertil Steril 2008 Sep; 90:557.