Survey of Long-Term Experiences of Sperm Cryopreservation in Oncological and Non-Oncological Patients: Usage and Reproductive Outcomes of a Large Monocentric Cohort.
Survey of Long-Term Experiences of Sperm Cryopreservation in Oncological and Non-Oncological Patients: Usage and Reproductive Outcomes of a Large Monocentric Cohort.
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DOI：
10.3389/fonc.2021.772809
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发表时间：
2021
影响因子：
4.7
通讯作者：
le Coutre P
中科院分区：
文献类型：
--
作者：
Lackamp N;Wilkemeyer I;Jelas I;Keller U;Bullinger L;Stintzing S;le Coutre P
在过去的几十年里，肿瘤治疗的进展已经改善了年轻男性癌症患者的长期生存率。然而，标准的癌症治疗往往涉及生育能力损害的潜力。精子冷冻保存是目前治疗后保留患者生育能力的标准选择，但有关使用和生殖经验的长期数据仍然有限。治疗后的自然生育能力，特别是与治疗类型的关系，迄今为止分析得很差。因此，我们进行了一项回顾性调查，包括1994年至2017年期间在我们机构冷冻保存生殖材料的男性患者，这些患者有性腺毒性治疗的适应症。将关于治疗、材料使用和生殖结果的研究问卷发送给合格的患者。此外，对冷冻保存后研究参与者的精液分析进行了评价。共有99名患者入选本研究。受访者的中位年龄为38.0岁。最常见的诊断是睾丸癌（29.3%）和淋巴瘤（26.3%）。另有8.1%患有自身免疫性疾病。与非睾丸癌患者（5420万/ml）相比，睾丸癌患者的治疗前中位精子浓度（1800万/ml）显著较低。截至2020年11月，每对夫妇的精子使用率和累积活产率分别为17.2%和58.8%。大多数精子使用者接受了高（40.0%）或中等（33.3%）性腺毒性的治疗。20.7%的患者报告在治疗后至少有一个自然受孕的孩子，特别是如果他们接受了较少或潜在的性腺毒性治疗。总之，我们的研究结果强调了精子冷冻保存在男性生育力保存方面的重要性。此外，他们指出，患者治疗的性腺毒性可能是精子使用的预测因素。
Progress in oncological treatment has led to an improved long-term survival of young male cancer patients over the last decades. However, standard cancer treatments frequently implicate fertility-damaging potential. Cryopreservation of sperm is the current standard option to preserve patient’s fertility after treatment, yet long-term data on usage and reproductive experiences is still limited. Natural fertility after treatment and especially in relation to the type of treatment has been poorly analyzed so far. Therefore, we performed a retrospective survey including male patients with an indication for gonadotoxic treatment who cryopreserved reproductive material at our institution between 1994 and 2017. Study questionnaires regarding treatment, material usage, and reproductive outcomes were sent to eligible patients. Additionally, semen analyses of study participants from the time of cryopreservation were evaluated. A total of 99 patients were included in the study. Respondents’ median age was 38.0 years. Most frequent diagnoses were testicular cancer (29.3%) and lymphoma (26.3%). A further 8.1% suffered from autoimmune diseases. Testicular cancer patients had a significantly lower pre-treatment median sperm concentration (18.0 million/ml) compared to non-testicular cancer patients (54.2 million/ml). Until November 2020, the determined sperm usage and cumulative live-birth rate per couple were 17.2% and 58.8%, respectively. Most sperm users received treatments with high (40.0%) or intermediate (33.3%) gonadotoxic potential. 20.7% of all patients reported to had fathered at least one naturally conceived child after treatment, this being the case especially if they had been treated with less or potentially gonadotoxic therapies. In conclusion, our findings emphasize the importance of sperm cryopreservation in the context of male fertility preservation. Furthermore, they indicate that the gonadotoxic potential of patients’ treatments could represent a predictive factor for sperm usage.
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影响因子：
5.2
作者：
Krouwel EM;Jansen TG;Nicolai MPJ;Dieben SWM;Luelmo SAC;Putter H;Pelger RCM;Elzevier HW
通讯作者：
Elzevier HW
影响因子：
4.5
作者：
Ferrari, Stefania;Paffoni, Alessio;Somigliana, Edgardo
通讯作者：
Somigliana, Edgardo
影响因子：
4.9
作者：
Depalo, Raffaella;Falagario, Doriana;Battaglia, Michele
通讯作者：
Battaglia, Michele
影响因子：
3.1
作者：
Fu, Longlong;Zhou, Fang;Gu, Yiqun
通讯作者：
Gu, Yiqun
影响因子：
3.3
作者：
Traila A;Dima D;Achimas-Cadariu P;Micu R
通讯作者：
Micu R