Liu Xiao, Liu Bo, Liu Shasha, Xian Yang, Zhao Wenrui, Zhou Bin, Xiao Xiao, Wang Li, Zhu Xiaofang, Shu Bizhen, Jiang Min, Li Fuping
Human Sperm Bank, Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Ministry of Education, Sichuan University, 610041, Sichuan, P.R. China.
Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Clinical Research Center for Birth Defects of Sichuan Province, West China Second University Hospital, Sichuan University, Ministry of Education, Sichuan University, 610041, Chengdu, Sichuan, P.R. China.
Basic Clin Androl. 2021 Sep 16;31(1):24. doi: 10.1186/s12610-021-00140-w.
Sperm cryopreservation, an effective method for preserving male fertility, is very advantageous for men suffering from cancer. Unfortunately, as both physicians and cancer patients are unaware of the possibilities for sperm cryopreservation, the data on evaluation of semen parameters and disposition of cryopreserved samples among Chinese cancer patients are scarce.
Male tumours were classified into six major types, germ cell tumours (26 %), haematological neoplasms (28 %), head and neck cancers (19 %), thoracic tumours (4 %), abdominal tumours (10 %), and others (13 %). Haematological neoplasm was the most prevalent cancer among our cohort of patients who opted for sperm banking, followed by germ cell tumours. Patients with germ cell tumours had the lowest pre-thaw and post-thaw seminal sperm concentrations. We separately compared patients with testicular tumours, lymphoma, and leukaemia, and found that leukaemia patients had the lowest pre-thaw sperm concentrations. Most cancer patients (58 %) chose to keep their specimens stored, while 31 % chose to discard the specimens. Over the years, only 13 patients (4 %) returned to use their spermatozoa by assisted reproductive technology. Of the stored samples, patients with germ cell tumours constituted the highest proportion (29.3 %). Moreover, the percentage of haematological neoplasm patients who had no spermatozoa frozen was the highest (46.2 %).
The present data confirm the deleterious impact of various cancers on semen quality. Leukaemia was associated with the worst semen quality and the highest number of semen samples that could not be frozen. We suggest that sperm quality may have decreased even before anti-neoplastic treatment and that sperm banking before treatment should be strongly recommended for cancer patients. A sperm banking programme before gonadotoxic therapy requires close cooperation between assisted reproduction centres and cancer clinics.
精子冷冻保存是一种保存男性生育能力的有效方法，对癌症患者非常有利。遗憾的是，由于医生和癌症患者都不了解精子冷冻保存的可能性，中国癌症患者精液参数评估及冷冻保存样本处置的数据稀缺。
男性肿瘤分为六大类，生殖细胞肿瘤（26%）、血液系统肿瘤（28%）、头颈癌（19%）、胸部肿瘤（4%）、腹部肿瘤（10%）及其他（13%）。血液系统肿瘤是我们选择精子库的患者队列中最常见的癌症，其次是生殖细胞肿瘤。生殖细胞肿瘤患者解冻前和解冻后的精液精子浓度最低。我们分别比较了睾丸肿瘤、淋巴瘤和白血病患者，发现白血病患者解冻前精子浓度最低。大多数癌症患者（58%）选择保留其标本，而31%选择丢弃标本。多年来，只有13名患者（4%）通过辅助生殖技术返回使用其精子。在储存的样本中，生殖细胞肿瘤患者占比最高（29.3%）。此外，血液系统肿瘤患者未冷冻到精子的比例最高（46.2%）。
目前的数据证实了各种癌症对精液质量的有害影响。白血病与最差的精液质量以及无法冷冻的精液样本数量最多有关。我们建议，甚至在抗肿瘤治疗之前精子质量可能就已下降，强烈建议癌症患者在治疗前进行精子库保存。性腺毒性治疗前的精子库计划需要辅助生殖中心和癌症诊所密切合作。
