Stigliani Sara, Massarotti Claudia, De Leo Caterina, Maccarini Elena, Sozzi Fausta, Cagnacci Angelo, Anserini Paola, Scaruffi Paola
Physiopathology of Human Reproduction, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, 16132 Genova, Italy.
Academic Unit of Obstetrics and Gynecology, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, 16132 Genova, Italy.
Cancers (Basel). 2021 Jan 1;13(1):116. doi: 10.3390/cancers13010116.
Cancer treatments frequently impair the reproductive ability of patients by damaging spermatogenesis. International guidelines recommend semen cryopreservation to preserve the fertility of oncological adult males and pubertal boys. However, due to the low usage rate of banked samples, not a lot of data on assisted reproductive treatments (ART) success rates in this population and follow-up data for children born are available in the literature. The aims of this study were to report our 15 years of experience, the clinical outcomes of ART as well as neonatal characteristics of babies born. We retrospectively reviewed 682 oncological patients who were referred to our center from 2004 to 2019 for fertility preservation. Over the years, only 26 patients (4%) returned to use their sperm by ART. They were survivors of leukemia and lymphomas (52%), testicular cancer (20%), and other malignant diseases (28%). These couples performed 45 cycles: 34 intracytoplasmic sperm injection (ICSI) plus 11 frozen embryo transfers. A total of 13 children were born, with 35% of the cumulative live-birth delivery rate per couple. No stillbirths or malformations were recorded. These successful findings demonstrated that pregnancy could be safely achieved using frozen-thawed sperm of cancer survivors who cryopreserved before gonadotoxic therapies.
癌症治疗常常会通过损害精子发生来损害患者的生殖能力。国际指南建议进行精液冷冻保存，以保留成年男性肿瘤患者和青春期男孩的生育能力。然而，由于储存样本的使用率较低，该人群辅助生殖治疗（ART）成功率以及所生孩子的随访数据在文献中并不多见。本研究的目的是报告我们15年的经验、ART的临床结局以及所生孩子的新生儿特征。我们回顾性分析了2004年至2019年转诊至我们中心进行生育力保存的682例肿瘤患者。多年来，只有26例患者（4%）通过ART使用他们的精子。他们是白血病和淋巴瘤幸存者（52%）、睾丸癌患者（20%）以及其他恶性疾病患者（28%）。这些夫妇共进行了45个周期：34个卵胞浆内单精子注射（ICSI）周期加11个冻融胚胎移植周期。共出生13名儿童，每对夫妇的累积活产分娩率为35%。未记录到死产或畸形情况。这些成功结果表明，使用在性腺毒性治疗前冷冻保存的癌症幸存者的冻融精子可以安全实现妊娠。
