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青春期男孩在性腺毒性治疗前的精液冷冻保存以及内分泌评估在预测精子产量中的作用。

Semen cryopreservation in pubertal boys before gonadotoxic treatment and the role of endocrinologic evaluation in predicting sperm yield.

作者信息

van Casteren Niels J, Dohle Gert R, Romijn Johanens C, de Muinck Keizer-Schrama Sabine M P F, Weber Robertus F A, van den Heuvel-Eibrink Marry M

机构信息

Department of Urology, Andrology Unit, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.

出版信息

Fertil Steril. 2008 Oct;90(4):1119-25. doi: 10.1016/j.fertnstert.2007.08.006. Epub 2007 Oct 1.

Abstract

OBJECTIVE

To evaluate the feasibility of semen cryopreservation in pubertal boys before they receive gonadotoxic therapy and to identify which pretreatment parameters might predict successful cryopreservation.

DESIGN

Retrospective data analysis.

SETTING

Tertiary fertility center, academic children's hospital.

PATIENT(S): Between 1995 and 2005, 80 boys (median age 16.6 years, range 13.7-18.9 years) consulted the outpatient clinic of andrology for semen cryopreservation before a potentially gonadotoxic treatment.

INTERVENTION(S): We assessed the pretreatment semen parameters, hormone levels, and patients' characteristics.

MAIN OUTCOME MEASURE(S): Measurement of the number of adolescents able to cryopreserve semen.

RESULT(S): Thirteen boys were unable to produce semen by masturbation. In 53 boys semen quality was adequate for cryopreservation. In 14 patients semen analysis did not show motile spermatozoa, and therefore semen cryopreservation could not be performed. Although inhibin B showed a strong correlation with sperm count, no significant difference was found in serum T, inhibin B, LH, and FSH levels in the patients with or without successful sperm yield. Moreover, median age was not different between patients with and without a successful sperm yield.

CONCLUSION(S): Semen cryopreservation in boys is a feasible method to preserve spermatozoa before gonadotoxic therapy is started and should be offered to all pubertal boys despite their young age. Serum hormone levels do not predict sperm yield.

摘要

目的

评估青春期男孩在接受性腺毒性治疗前进行精液冷冻保存的可行性,并确定哪些预处理参数可预测冷冻保存成功。

设计

回顾性数据分析。

地点

三级生殖中心,学术儿童医院。

患者

1995年至2005年间,80名男孩(中位年龄16.6岁,范围13.7 - 18.9岁)在可能进行性腺毒性治疗前到男科门诊咨询精液冷冻保存事宜。

干预措施

我们评估了预处理精液参数、激素水平和患者特征。

主要观察指标

测量能够冷冻保存精液的青少年人数。

结果

13名男孩无法通过手淫产生精液。53名男孩的精液质量足以进行冷冻保存。14名患者的精液分析未显示有活动精子,因此无法进行精液冷冻保存。尽管抑制素B与精子计数有很强的相关性,但在精液采集成功与否的患者中,血清睾酮、抑制素B、促黄体生成素和促卵泡生成素水平均未发现显著差异。此外,精液采集成功和未成功的患者中位年龄无差异。

结论

男孩精液冷冻保存是在开始性腺毒性治疗前保存精子的一种可行方法,尽管年龄较小,也应提供给所有青春期男孩。血清激素水平不能预测精子采集情况。

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