Abstract
Objective
To assess clinical outcome among infertile couples treated by in vitro fertilization
(IVF) and intra cytoplasmic sperm injection (ICSI) using testicular sperm from azoospermic
cancer survivors.
Study design
This clinical retrospective study included infertile couples treated in a single tertiary
referral center between 1996 and 2013. All male partners were cancer survivors who
were diagnosed with azoospermia due to previous gonadotoxic treatments and referred
to testicular sperm extraction (TESE). Retrieved sperm was used for IVF-ICSI among
patients’ spouses. Sperm retrieval rate and IVF-ICSI outcome were evaluated.
Results
Sperm was successfully retrieved in 12 out of 36 patients (33.3%) on initial TESE,
with an overall sperm retrieval rate of 38.6% (17 of 44). Female patients were 29.8 ± 5.1 years old. The average number of retrieved oocytes was 14.0 ± 4.0 per cycle, with clinical pregnancy and live birth rates per successful TESE of
64% (11 of 17) and 58.8% (10 of 17), respectively. Age, serum FSH, testicular volume
and time from chemotherapy to TESE were not significantly different between patients
with successful TESE to those without. Patients suffering from seminomas had significantly
higher sperm retrieval rate, as compared to patients who had Hodgkin’s lymphoma (P = 0.024).
Conclusions
Post-chemotherapy azoospermia can be successfully treated with TESE and ICSI, and
should be offered to azoospermic cancer survivors who did not cryopreserve sperm prior
to their gonadotoxic treatments.
Keywords
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References
- Clinical and biochemical correlates of successful semen collection for cryopreservation from 12–18-year-old patients: a single-center study of 86 adolescents.Hum Reprod. 2010; 25: 2031-2038
- Cancer survivors–United States, 2007.MMWR Morb Mortal Wkly Rep. 2011; 60: 269-272
- The impact of chemotherapy on male fertility: a survey of the biologic basis and clinical aspects.Reprod Toxicol. 2001; 15: 611-617
- Toxicity of chemotherapy and radiation on female reproduction.Clin Obstet Gynecol. 2010; 53: 727-739
- Preserving the reproductive potential of men and boys with cancer: current concepts and future prospects.Hum Reprod Update. 2004; 10: 525-532
- Use rate and assisted reproduction technologies outcome of cryopreserved semen from 629 cancer patients.Fertil Steril. 2008; 90: 2245-2250
- Fertility preservation medicine: options for young adults and children with cancer.J Pediatr Hematol Oncol. 2010; 32: 390-396
- Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte.Lancet. 1992; 340: 17-18
- Intracytoplasmic sperm injection (ICSI) for severe semen abnormalities: dissecting the tail of spermatozoa at the tip.Hum Reprod. 1996; 11: 2640-2644
- Testicular function following chemotherapy.Hum Reprod Update. 2001; 7: 363-369
- Fertility after high-dose chemotherapy for testicular cancer.Urology. 2004; 63: 137-140
- Increased aneuploidy in spermatozoa from testicular tumour patients after chemotherapy with cisplatin, etoposide and bleomycin.Hum Reprod. 2001; 16: 1204-1208
- Gonadal function in males after chemotherapy for early-stage Hodgkin's lymphoma treated in four subsequent trials by the European Organisation for Research and Treatment of Cancer: EORTC Lymphoma Group and the Groupe d'Etude des Lymphomes de l'Adulte.Jo Clin Oncol. 2007; 25: 2825-2832
- Fertility after testicular cancer treatments: results of a large multicenter study.Cancer. 2004; 100: 732-737
- Testicular sperm extraction and ICSI in patients with post-chemotherapy non-obstructive azoospermia.Arch Androl. 2007; 53: 63-65
- Successful treatment of postchemotherapy azoospermia with microsurgical testicular sperm extraction: the Weill Cornell experience.J Clin Oncol. 2011; 29: 1607-1611
- Postchemotherapy ejaculatory azoospermia: fatherhood with sperm from testis tissue with intracytoplasmic sperm injection.J Clin Oncol. 2002; 20: 930-936
- Effects of male age on semen quality and fertility: a review of the literature.Fertil Steril. 2001; 75: 237-248
- Microdissection testicular sperm extraction in Japanese patients with persistent azoospermia after chemotherapy.Int J Clin Oncol. 2016; 21 (Epub 2016 Jun 15): 1167-1171
Article info
Publication history
Published online: November 20, 2017
Accepted:
November 19,
2017
Received in revised form:
November 14,
2017
Received:
July 6,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
