Fertility preservation in males with cancer: 16-year monocentric experience of sperm banking and post-thaw reproductive outcomes
Fertility preservation in males with cancer: 16-year monocentric experience of sperm banking and post-thaw reproductive outcomes
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DOI：
10.1177/1758834016665078
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发表时间：
2016-11-01
影响因子：
4.9
通讯作者：
Battaglia, Michele
中科院分区：
文献类型：
--
作者：
Depalo, Raffaella;Falagario, Doriana;Battaglia, Michele
背景：抗癌治疗会损害男性生育能力。精液冷冻保存是保存生育能力的有效方法。本研究的目的是评估各种类型的癌症，解冻后的精子活力和用于辅助生殖治疗（ART）的样本的生殖结果之间的预冻精液参数。方法：本研究包括721名男性癌症患者，他们的精液在1999年至2015年在我们的银行冷冻保存。根据世界卫生组织的建议、欧盟委员会和意大利法律，精液分析和冷冻保存在开始接受抗精子抗体治疗前进行。其中睾丸腺瘤196例，霍奇金淋巴瘤173例，睾丸混合瘤108例，生殖细胞肿瘤89例，其他肿瘤67例，血液系统肿瘤46例，42例非霍奇金淋巴瘤霍奇金淋巴瘤患者的平均年龄明显低于其他肿瘤。霍奇金淋巴瘤、睾丸混合瘤和血液系统肿瘤的精子体积、精子计数和精子管储存数均显著低于正常对照组。19名患者使用他们的冷冻精液进行了20个ART周期。解冻后，记录到运动性和活力显著降低。睾丸肿瘤和淋巴瘤患者的受精率（35.42%和50%）低于其他癌症患者（71.43%）。在卵裂率和着床率方面没有观察到显著差异。共五个怀孕和七个健康的新生儿achieved.Conclusions：生育能力的保存前的性腺毒性治疗是非常重要的癌症患者，必须表明开始治疗前。
Background: Anticancer treatments can impair male fertility. Cryopreservation of semen is an efficient procedure for fertility preservation. The aim of this study was to evaluate pre-freeze semen parameters among the various types of cancer, post-thaw sperm viability and reproductive outcome of samples used for assisted reproductive treatment (ART).Methods: This study included 721 men with cancer that had their semen cryopreserved in our bank in 1999-2015. Semen analysis and cryopreservation were performed before the start of antineoplastic treatment, according to the World Health Organization recommendations, European Commission and Italian law.Results: Among the 721 patient, 196 had seminoma of the testis, 173 Hodgkin's lymphoma, 108 mixed testicular tumors, 89 germ cell tumors, 67 other tumors, 46 hematological tumors, and 42 non-Hodgkin's lymphoma. The mean age of patients was significantly lower in Hodgkin's lymphoma compared to other tumors. Statistically significant lower volume, sperm count and number of straws stored were observed respectively in Hodgkin's lymphoma, mixed testicular tumor and hematological tumors. Nineteen patients used their frozen semen for 20 ART cycles. After thawing a significant reduction of motility and vitality was recorded. A lower fertilization rate was observed in patients affected by testicular tumor and lymphoma (35.42% and 50%) compared with other cancers (71.43%). No significant differences were observed in terms of cleavage and implantation rates. A total of five pregnancies and seven healthy newborns were achieved.Conclusions: Fertility preservation before gonadotoxic therapy is of great importance to patients with cancer and must be indicate before the start of treatment.