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癌症治疗前的精子冷冻保存:15 年单中心经验。

Sperm cryopreservation before cancer treatment: a 15-year monocentric experience.

机构信息

Aix-Marseille Université, AP-HM La Conception, CECOS-Laboratoire de Biologie de la Reproduction, Pôle de Gynécologie-Obstétrique et Reproduction, 147, Boulevard Baille, 13005 Marseille, France.

出版信息

Reprod Biomed Online. 2012 Mar;24(3):321-30. doi: 10.1016/j.rbmo.2011.11.015. Epub 2011 Dec 2.

Abstract

Sperm banking is an important procedure to preserve fertility before cancer therapy. The aim of this study was to comprehensively analyse cryopreservation activity retrospectively for 1080 patients referred to the sperm bank for sperm cryopreservation before cancer treatment. This study included 1007 patients diagnosed with testicular cancer (TC) (41.7%), lymphoma (26%), other haematological cancers (9.4%) or other types of cancer (22.8%); of these, 29 patients did not produce any semen sample and cryopreservation was impossible for 67 patients. Semen characteristics before treatment were within normal ranges, except moderate asthenospermia. Sperm concentration was significantly lower in TC than in non-TC. Straws from 57 patients (6.3%) were used in assisted reproductive technologies, which led to a 46.8% cumulative birth rate. Straws were destroyed for 170 patients (18.7%) and 140 patients performed semen analyses after cancer therapy. After an average delay of 22.5 months after the end of therapy, 43 patients (30.7%) exhibited azoospermia. This study of a large population of cancer patients revealed a high level of successful sperm storage. Utilization of cryopreserved spermatozoa led to good chances of fatherhood. Nevertheless, sperm banks should be aware of the low rates of straw use and straw destruction by cancer patients.

摘要

精子库是癌症治疗前保存生育能力的重要程序。本研究旨在全面分析 1080 名因癌症治疗前精子冷冻而向精子库就诊的患者的冷冻保存情况。本研究包括 1007 名被诊断为睾丸癌(TC)(41.7%)、淋巴瘤(26%)、其他血液癌症(9.4%)或其他类型癌症(22.8%)的患者;其中 29 名患者没有产生任何精液样本,67 名患者冷冻保存不可能。治疗前的精液特征在正常范围内,除了中度精子活力不足。TC 患者的精子浓度明显低于非 TC 患者。57 名患者(6.3%)的 straws 用于辅助生殖技术,累计出生率为 46.8%。170 名患者(18.7%)的 straws 被销毁,140 名患者在癌症治疗后进行了精液分析。治疗结束后平均延迟 22.5 个月后,43 名患者(30.7%)出现无精子症。这项针对大量癌症患者的研究显示出高水平的成功精子储存。利用冷冻保存的精子有很好的生育机会。然而,精子库应该意识到癌症患者 straw 使用和 straw 销毁的低比率。

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