Daudin Myriam, Rives Nathalie, Walschaerts Marie, Drouineaud Véronique, Szerman Ethel, Koscinski Isabelle, Eustache Florence, Saïas-Magnan Jacqueline, Papaxanthos-Roche Aline, Cabry-Goubet Rosalie, Brugnon Florence, Le Lannou Dominique, Barthélémy Claire, Rigot Jean-Marc, Fréour Thomas, Berthaut Isabelle, Giscard d'Estaing Sandrine, Touati Françoise, Mélin-Blocquaux Marie-Claude, Blagosklonov Oxana, Thomas Claire, Benhamed Mohamed, Schmitt Françoise, Kunstmann Jean-Marie, Thonneau Patrick, Bujan Louis
CECOS Midi-Pyrénées, University Hospital of Toulouse, Hôpital Paule de Viguier, Toulouse, France; Groupe de Recherche en Fertilité Humaine (EA 3694, Human Fertility Research Group), Université de Toulouse-UPS, Toulouse, France.
CECOS Haute-Normandie, Reproductive Biology Laboratory and EA 4308 (Spermatogenesis and Male Gamete Quality), Rouen University Hospital, Rouen, France.
Fertil Steril. 2015 Feb;103(2):478-86.e1. doi: 10.1016/j.fertnstert.2014.11.012. Epub 2014 Dec 17.
To determine the feasibility of fertility preservation in adolescent males with cancer.
Large multicenter retrospective study of male patients ≤20 years from 23 centers of a national network of sperm banks over a 34-year period.
Sperm banks.
PATIENT(S): A total of 4,345 boys and young men aged 11 to 20 years.
INTERVENTION(S): Age, cancer diagnosis, feasibility of sperm banking, and sperm parameters.
MAIN OUTCOME MEASURE(S): Description of patients, and success of their fertility preservation.
RESULT(S): We observed a mean yearly increase in referred patients of 9.5% (95% confidence interval, 9.1%-9.8%) between 1973 and 2007. Over the study period, the percentage of younger cancer patients who banked their sperm increased, especially in the 11-14 year age group, rising from 1% in 1986 to 9% in 2006. We found that 4,314 patients attempted to produce a semen sample, 4,004 succeeded, and sperm was banked for 3,616. The mean total sperm count was 61.75 × 10(6) for the 11-14 year age group, and 138.81 × 10(6) for the 18-20 year age group. It was noteworthy that intercenter variations in practices involving young patients seeking to preserve their fertility before cancer therapy were observed within this national network.
CONCLUSION(S): Our results emphasize the need for decisive changes in public health policy to facilitate the access to reproductive health-care for young cancer patients.
确定癌症青少年男性保存生育能力的可行性。
对来自全国精子库网络23个中心的20岁及以下男性患者进行的大型多中心回顾性研究，为期34年。
精子库。
共4345名年龄在11至20岁的男孩和青年男性。
年龄、癌症诊断、精子库保存的可行性以及精子参数。
患者描述及其生育能力保存的成功率。
我们观察到1973年至2007年间转诊患者年均增长9.5%（95%置信区间，9.1%-9.8%）。在研究期间，保存精子的年轻癌症患者比例有所增加，尤其是在11-14岁年龄组，从1986年的1%升至2006年的9%。我们发现4314名患者尝试采集精液样本，4004名成功，3616名患者的精子被保存。11-14岁年龄组的平均精子总数为61.75×10⁶，18-20岁年龄组为138.81×10⁶。值得注意的是，在这个全国性网络中，观察到涉及年轻患者在癌症治疗前寻求保存生育能力的实践存在中心间差异。
我们的结果强调公共卫生政策需要进行决定性变革，以促进年轻癌症患者获得生殖保健服务。
