Variables affecting long-term usage rate of sperm samples cryopreserved for fertility preservation in cancer patients
Variables affecting long-term usage rate of sperm samples cryopreserved for fertility preservation in cancer patients
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DOI：
10.1111/andr.12894
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发表时间：
2020-09-09
期刊：
影响因子：
4.5
通讯作者：
Somigliana, Edgardo
中科院分区：
文献类型：
--
作者：
Ferrari, Stefania;Paffoni, Alessio;Somigliana, Edgardo
背景以前的证据强调，在癌症治疗前储存精液的男性中，只有一小部分人后来使用了他们的冷冻样本。这可能会质疑精子冷冻保存计划的经济有效性。然而，在大多数捐款中，后续行动的持续时间不足以得出关于实际使用率的可靠信息。目的更多地了解冷冻保存计划的潜在益处。材料与方法回顾1986-2009年间在公立医院冷冻精液以诊断为癌症的男性。对使用率以及可能的决定因素进行了调查。结果中位随访时间12[IQR：7~16]年。在1,524例患者中，144例(9.4%，95%CI：8.1%-11.0%)使用了冷冻标本，其中%为无精子症。男性使用冷冻精液为人父母的比例为46%。使用的预测因素是储存时的年龄较大，储存时精子数量较低，以及睾丸癌的诊断。后一因素的影响也被这些患者癌症治疗后无精子症的较低频率所支持。讨论：有必要进行成本效益研究，以评估并可能提高精子库的经济有效性。结论癌症患者冷冻精子使用率低，甚至延长了随访时间。
Background Previous evidence highlighted that only a minority of men who banked their semen before cancer therapies subsequently used their frozen samples. This may question the economical validity of sperm cryopreservation programmes. However, in most contributions, the duration of follow-up was insufficient to draw robust information on the real rate of use. Objectives To shed more light on the potential benefits of cryopreservation programmes. Materials and methods Men who cryopreserved their semen in a public hospital for a diagnosis of cancer between 1986 and 2009 were retrospectively reviewed. The rate of use as well as the possible determinants was investigated. Results The median time of follow-up was 12 [IQR: 7-16] years. One hundred forty-four patients out of 1,524 (9.4%, 95%CI: 8.1%-11.0%) used their frozen samples of whom 64% were azoospermic. The rate of men achieving parenthood with frozen semen was 46%. Predictive factors of use were older age at the time of storage, lower sperm count at the time of storage and a diagnosis of testicular cancer. The impact of this latter factor was also supported by the lower frequency of azoospermia after cancer treatment in these patients. Discussion Cost-beneficial studies are warranted to assess and possibly improve the economical validity of sperm banking. Conclusion The usage rate of frozen sperm in cancer patient is low, even extending the duration of follow-up.