Molnár Z, Berta E, Benyó M, Póka R, Kassai Z, Flaskó T, Jakab A, Bodor M
Pharmazie. 2014 Jun;69(6):437-41.
Testicular cancer affects men mostly in their reproductive age with a cure rate over 90%. Preserved fertility is one of the main concerns of the survivors. To further elucidate the question of fertility after anticancer treatment for testicular cancer, we performed a survey among patients who underwent sperm cryopreservation procedure in our department. A structured questionnaire was designed to collect data on demography, anticancer treatment, histological type of cancer, family planning intentions and fertility prior to and after treatment. During a period of 11 years 86 men underwent semen cryopreservation before starting chemo-or radiotherapy. Fifty-nine of them consented to participate in the study. The average length of follow up was 4.6 +/- 3.8 years. In case of 11.9% of the patients their banked sperm was used, which led to live birth in 57% of the couples. The partners of 6 patients became pregnant after in vitro fertilization (IVF) resulting in 4 live births and 2 miscarriages. The spontaneous pregnancy rate was 22%. Spontaneous pregnancy occurred in 13 partners resulting in 18 pregnancies followed by 12 live births, 2 artificial abortions and 4 miscarriages. We could not prove any association between preserved fertility and anticancer treatment or the histological type of the cancer. In conclusion, although spontaneous pregnancy rate is remarkably high after anticancer treatment for testicular cancer, the risk of infertility after receiving gonadotoxic treatment cannot be predicted. Cryopreservation is a safe and effective method to preserve fertility in these cases. As a result we strongly recommend discussing the advantages of semen cryopreservation with all patients awaiting treatment for testicular cancer.
睾丸癌主要影响处于生育年龄的男性，其治愈率超过90%。保留生育能力是幸存者的主要关注点之一。为了进一步阐明睾丸癌抗癌治疗后的生育问题，我们对在我科接受精子冷冻保存程序的患者进行了一项调查。设计了一份结构化问卷，以收集有关人口统计学、抗癌治疗、癌症组织学类型、计划生育意向以及治疗前后生育能力的数据。在11年的时间里，86名男性在开始化疗或放疗前进行了精液冷冻保存。其中59人同意参与研究。平均随访时间为4.6±3.8年。11.9%的患者使用了储存的精子，这使得57%的夫妇成功分娩。6名患者的伴侣在体外受精（IVF）后怀孕，其中4例成功分娩，2例流产。自然怀孕率为22%。13名伴侣自然怀孕，共18次妊娠，随后有12例活产、2例人工流产和4例流产。我们无法证明保留生育能力与抗癌治疗或癌症组织学类型之间存在任何关联。总之，尽管睾丸癌抗癌治疗后的自然怀孕率非常高，但接受性腺毒性治疗后不孕的风险无法预测。在这些情况下，冷冻保存是一种安全有效的保留生育能力的方法。因此，我们强烈建议与所有等待睾丸癌治疗的患者讨论精液冷冻保存的好处。
