Chatterton Fiona, Kay Vanessa
a University of Dundee , Dundee , Scotland.
J Obstet Gynaecol. 2018 Jul;38(5):732. doi: 10.1080/01443615.2018.1444396.
Infertility is a devastating consequence of some medical and surgical interventions. Men can protect their fertility by storing or 'banking' sperm before beginning treatment. This is called fertility preservation. Fertility preservation is traditionally offered to cancer patients undergoing gonadotoxic therapy.
This study reports the results of an audit of the Ninewells Hospital fertility preservation service. It aims to characterise the patients who attended our service and assess their utilisation rate and outcome of treatment.
A retrospective study carried out between January 2000 and March 2017. Data was collected using a combination of laboratory and clinical records.
A total of 296 patients attended for fertility preservation, of which 264 banked sperm. The number of men referred for sperm banking increased during the study period from 3 in 2000 to 26 in 2016. Testicular cancer (41.7%) was the most common indication followed by, haematological malignancies (33.0%), other malignancies (15.2%) and benign disease (10.2%). The proportion of men with benign disease increased over-time and accounted for 15% of all patients since 2015. At the time of sperm banking, the median age was 29.8 years. Fourteen men (5.3%) returned for fertility treatment with their banked sperm after an average of 40.8 months. After a total of 32 treatment cycles, 12 babies were born (6 singletons and 3 twins). Eight of the fourteen couples succeeded in having at least one child (57.1%). A small proportion of men engaged in fertility monitoring (9.5%) or disposed of their banked sperm (5.7%).
There is an increasing demand for fertility preservation, especially from patients with benign disease. Only a small proportion of men utilised their banked sperm, however, those that did had a good chance of becoming fathers. Data from this study will be used to review our referral pathways and inform our future practice.
不孕是一些医学和外科干预的灾难性后果。男性可以在开始治疗前通过储存或“保存”精子来保护自己的生育能力。这被称为生育力保存。传统上，生育力保存是提供给接受性腺毒性治疗的癌症患者的。
本研究报告了对九井医院生育力保存服务的一次审核结果。其目的是描述前来我们服务的患者特征，并评估他们的利用率和治疗结果。
在2000年1月至2017年3月期间进行了一项回顾性研究。通过结合实验室和临床记录收集数据。
共有296名患者前来进行生育力保存，其中264人保存了精子。在研究期间，转诊进行精子保存的男性人数从2000年的3人增加到2016年的26人。睾丸癌（41.7%）是最常见的适应症，其次是血液系统恶性肿瘤（33.0%）、其他恶性肿瘤（15.2%）和良性疾病（10.2%）。患有良性疾病的男性比例随时间增加，自2015年以来占所有患者的15%。在进行精子保存时，中位年龄为29.8岁。14名男性（5.3%）在平均40.8个月后带着他们保存的精子回来进行生育治疗。在总共32个治疗周期后，出生了12名婴儿（6名单胎和3对双胞胎）。14对夫妇中有8对成功育有至少一个孩子（57.1%）。一小部分男性进行了生育力监测（9.5%）或处理了他们保存的精子（5.7%）。
对生育力保存的需求在增加，尤其是来自患有良性疾病的患者。然而，只有一小部分男性使用了他们保存的精子，不过，那些使用了的男性有很大机会成为父亲。本研究的数据将用于审查我们的转诊途径并为我们未来的实践提供参考。
