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543例睾丸癌患者冷冻保存前和解冻后的精液质量

Semen quality before cryopreservation and after thawing in 543 patients with testicular cancer.

作者信息

MacKenna Antonio, Crosby Javier, Huidobro Cristián, Correa Eduardo, Duque Gonzalo

机构信息

Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Clínica Las Condes, Santiago-Chile.

Fellow in Obstetrics and Gynecology, Faculty of Medicine, Universidad de Chile.

出版信息

JBRA Assist Reprod. 2017 Feb 1;21(1):31-34. doi: 10.5935/1518-0557.20170009.

Abstract

OBJECTIVE

The main objective of this study was to assess semen characteristics of patients with testicular cancer before cryopreservation and after thawing, to evaluate the consequences of this technique on sperm quality in patients with testicular cancer.

METHODS

Five hundred eighty-nine samples from 543 patients with testicular cancer were cryopreserved between 1995 and 2015, one aliquot per patient was used for a thawing test to assess the impact of cryopreservation on sperm motility; semen analysis was performed before cryo preservation and after thawing, the result interpretation was carried out using the 2010 World Health Organization (WHO) Laboratory Manual, and consent forms were signed by the patients for freezing and when sperm was used for reproductive purposes.

RESULTS

Hypospermia was observed in 28.7% of samples, the median sperm concentration was 18 million/mL with 35% oligozoospermia; twenty-two patients (4.1%) had azoospermia and 12.7% had severe oligozoospermia, the median sperm count was 31.3 million and 261 semen samples (44.3%) were normal in all parameters according to the WHO; total motile sperm count before cryopreservation and after thawing was 12 (0-412.2) and 7 (0-303.9) million sperm, respectively (p < 0.00001, 95% CI 5.48-14.91), which represents a 32% reduction; concerning the utilization of cryopreserved semen samples, only twelve patients (2.2%) used their frozen sperm for reproductive purposes.

CONCLUSIONS

An impairment in semen quality was found in almost half of the samples from patients with testicular cancer, only few patients had azoospermia or severe oligozoospermia; sperm cryopreservation significantly reduces sperm motility and total motile sperm count and very few patients use their frozen sperm for reproductive purposes.

摘要

目的

本研究的主要目的是评估睾丸癌患者在冷冻保存前和解冻后的精液特征,以评估该技术对睾丸癌患者精子质量的影响。

方法

1995年至2015年间,对543例睾丸癌患者的589份样本进行了冷冻保存,每位患者的一份等分样本用于解冻测试,以评估冷冻保存对精子活力的影响;在冷冻保存前和解冻后进行精液分析,结果解读采用2010年世界卫生组织(WHO)实验室手册,患者签署了冷冻同意书以及精子用于生殖目的时的同意书。

结果

28.7%的样本出现少精子症,精子浓度中位数为1800万/mL,其中35%为少精子症;22例患者(4.1%)无精子症,12.7%为严重少精子症,精子计数中位数为3130万,根据WHO标准,261份精液样本(44.3%)所有参数均正常;冷冻保存前和解冻后的总活动精子数分别为12(0 - 412.2)万和7(0 - 303.9)万精子(p < 0.00001,95% CI 5.48 - 14.91),减少了32%;关于冷冻保存精液样本的使用,只有12例患者(2.2%)将其冷冻精子用于生殖目的。

结论

在睾丸癌患者近一半的样本中发现精液质量受损,只有少数患者有无精子症或严重少精子症;精子冷冻保存显著降低精子活力和总活动精子数,很少有患者将其冷冻精子用于生殖目的。

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