Hallak J, Kolettis P N, Sekhon V S, Thomas A J, Agarwal A
Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA.
Urology. 1999 Nov;54(5):894-9. doi: 10.1016/s0090-4295(99)00267-8.
To review a large experience with sperm cryopreservation in patients with testicular cancer and determine the effect of clinical stage and tumor histologic features on semen quality.
The prefreeze and post-thaw sperm quality of 157 patients with testicular cancer was compared with that of 50 normal donors. The impact of tumor stage and histologic features (pure seminoma, pure embryonal, or mixed germ cell) was also determined. A computer-assisted semen analysis was performed before and after cryopreservation. The motile sperm count (MSC), motility, and motion characteristics were measured before and after cryopreservation and compared between groups.
Patients with testicular cancer had lower prefreeze and post-thaw MSC and motility compared with normal donors (P = 0.0001 for both). The curvilinear velocity and linearity were also significantly less in patients with testicular cancer (P <0.05 for both). The percentage of change in the semen characteristics did not differ between patients and donors, indicating that sperm from both patients and donors withstood the cryopreservation process equally well. Tumor stage (n = 143) and histologic features (n = 136) did not significantly influence semen quality. No individual histologic component significantly influenced MSC or motility.
The effect of cryopreservation on sperm was similar in patients with testicular cancer and donors. Patients with poor prefreeze semen quality have poor post-thaw semen quality, and the effects of cryopreservation were not significantly affected by histologic features or stage. Our results indicate that routine sperm banking should be recommended for men with a diagnosis of testicular cancer to preserve future fertility potential.
回顾大量睾丸癌患者精子冷冻保存的经验，并确定临床分期和肿瘤组织学特征对精液质量的影响。
将157例睾丸癌患者冷冻前和解冻后的精子质量与50例正常供者的精子质量进行比较。还确定了肿瘤分期和组织学特征（纯精原细胞瘤、纯胚胎性癌或混合性生殖细胞肿瘤）的影响。在冷冻保存前后进行计算机辅助精液分析。测量冷冻保存前后的活动精子计数（MSC）、活力和运动特征，并在组间进行比较。
与正常供者相比，睾丸癌患者冷冻前和解冻后的MSC和活力较低（两者P = 0.0001）。睾丸癌患者的曲线速度和直线性也显著较低（两者P <0.05）。患者和供者精液特征的变化百分比没有差异，表明患者和供者的精子在冷冻保存过程中的耐受程度相同。肿瘤分期（n = 143）和组织学特征（n = 136）对精液质量没有显著影响。没有单个组织学成分对MSC或活力有显著影响。
冷冻保存对睾丸癌患者和供者精子的影响相似。冷冻前精液质量差的患者解冻后精液质量也差，冷冻保存的效果不受组织学特征或分期的显著影响。我们的结果表明，对于诊断为睾丸癌的男性，应建议常规进行精子库保存以保留未来的生育潜力。
