Humanitas Fertility Centre, Department of Gynecology, Division of Gynecology and Reproductive Medicine, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089, Rozzano, Milan, Italy.
Department of Obstetrics, Gynaecology and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT, USA.
J Assist Reprod Genet. 2020 Apr;37(4):875-882. doi: 10.1007/s10815-020-01697-7. Epub 2020 Jan 24.
To assess rates of successful testicular sperm retrieval and intracytoplasmic sperm injection (ICSI) outcome in cancer survivors affected by non-obstructive azoospermia (NOA) or retrograde ejaculation (RE)/failure of emission (FOE).
A retrospective analysis of cancer survivors who did not cryopreserve sperm prior to treatment undergoing testicular sperm extraction (TESE). Non-cancer NOA patients and neurologic RE/FOE were the control group.
A total of 97 cancer survivors were offered TESE and 88 (91%) accepted. Sperm was retrieved and cryopreserved in 34/67 patients with NOA (50.7%) and in 21/21 patients affected by RE/FOE (100%). Sperm retrieval rates were similar in the control group (44.9% in NOA and 100% in RE/FOE). The ICSI cumulative pregnancy rate (60%) and live birth rate (40%) per couple in 30 NOA men did not differ from controls (50.0 and 46.5%, respectively; p = 0.399/0.670). The cumulative pregnancy rate (66.7%) and live birth rate (55.6%) in 18 RE/FOE men did not differ from the control group (38.9 and 33.3%, respectively; p = 0.181/0.315). The cancer type and the resulting infertility disorder (NOA or RE/FOE) were not associated with ICSI outcomes. Female partner age was inversely related to the cumulative live birth rate, being fourfold lower (11.5%) in women ≥ 40 years and 48.8% in younger women (p = 0.0037).
The rate of successful TESE and the ICSI outcome in cancer survivors with NOA and RE/FOE is the same as non-cancer azoospermic patients. Female partner age (older than 40 years) was associated with a significant reduction in live birth rates after TESE-ICSI procedures.
评估非梗阻性无精子症（NOA）或逆行射精（RE）/射精失败（FOE）的癌症幸存者行睾丸精子提取（TESE）后精子获取和卵胞浆内单精子注射（ICSI）结局的成功率。
对未在治疗前冷冻精子的癌症幸存者进行回顾性分析，这些幸存者接受了 TESE 手术。非癌症性 NOA 患者和神经源性 RE/FOE 为对照组。
共有 97 名癌症幸存者接受了 TESE 检查，其中 88 名（91%）接受了该检查。在 34 名 NOA 患者（50.7%）和 21 名 RE/FOE 患者（100%）中成功获取并冷冻精子。在对照组中，精子获取率相似（NOA 中为 44.9%，RE/FOE 中为 100%）。30 名 NOA 男性的 ICSI 累积妊娠率（60%）和活产率（40%）与对照组无差异（分别为 50.0%和 46.5%；p=0.399/0.670）。18 名 RE/FOE 男性的累积妊娠率（66.7%）和活产率（55.6%）与对照组无差异（分别为 38.9%和 33.3%；p=0.181/0.315）。癌症类型和由此导致的不育症（NOA 或 RE/FOE）与 ICSI 结局无关。女性伴侣年龄与累积活产率呈反比，年龄≥40 岁的女性活产率降低至四倍（11.5%），而年龄较小的女性活产率为 48.8%（p=0.0037）。
NOA 和 RE/FOE 的癌症幸存者行 TESE 和 ICSI 的成功率与非癌症性无精子症患者相同。女性伴侣年龄（大于 40 岁）与 TESE-ICSI 后活产率显著降低有关。
