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癌症对冷冻保存精子质量和生育能力的影响:一项队列研究。

Impact of cancer on cryopreserved sperm quality and fertility: A cohort study.

作者信息

Pening David, Constant Marnie, Bruynbroeck Manon, Delbaere Anne, Demeestere I

机构信息

Department of Obstetrics and Gynecology, Fertility Clinic CUB-Erasme Hospital Brussels Belgium.

Research Laboratory on Human Reproduction Erasme Campus Université Libre de Bruxelles Brussels Belgium.

出版信息

Health Sci Rep. 2022 Jul 20;5(4):e726. doi: 10.1002/hsr2.726. eCollection 2022 Jul.

Abstract

BACKGROUND

Sperm quality at cancer diagnosis is often compromised by the disease and any given gonadotoxic treatment will further diminish fertility.

OBJECTIVES

Here, we aim to analyze the cryopreserved sperm quality according to the cancer types as well as the fertility outcomes.

METHODS

Our study included all cancer patients who cryopreserved sperm over 20 years at Erasme Hospital Brussels (from 1999 to 2019). First sperm samples from 111 hematologic, 104 testicular, 19 prostate, 28 gastrointestinal, and 16 neurological cancer patients were compared.

RESULTS

Oligozoo-asthenozoospermia was observed in 30% of the samples, including 19.33% with severe oligozoospermia (<5 million/ml). Our results showed a significant reduction in sperm concentration among testicular cancer ( < 0.01). No significant differences in progressive motility, sperm volume, and number of frozen straws were observed. Significant correlations were found between sperm concentration and cancer type ( <0.01) as well as patients' age ( <0.01). Twenty-eight cancer survivors returned for using their cryopreserved sperm (9.33%), fertilization rate was 60.5% and implantation rate was 29.6%. There was no correlation between sperm concentration and fertility outcomes.

CONCLUSION

Our results confirm the negative impact of cancer on sperm quality without affecting assisted reproductive technology (ART) success rate, which is utterly important as a male reproductive health perspective. All cancer patients should be counselled and offered fertility preservation options as a gold standard.

摘要

背景

癌症诊断时的精子质量常因疾病而受损,任何特定的性腺毒性治疗都会进一步降低生育能力。

目的

在此,我们旨在根据癌症类型以及生育结果分析冷冻保存的精子质量。

方法

我们的研究纳入了在布鲁塞尔伊拉斯谟医院20年间(1999年至2019年)冷冻保存精子的所有癌症患者。比较了111例血液系统癌症、104例睾丸癌、19例前列腺癌、28例胃肠道癌和16例神经癌症患者的首次精子样本。

结果

30%的样本中观察到少弱精子症,其中严重少精子症(<500万/毫升)的占19.33%。我们的结果显示睾丸癌患者的精子浓度显著降低(<0.01)。在进行性运动、精液量和冷冻细管数量方面未观察到显著差异。发现精子浓度与癌症类型(<0.01)以及患者年龄(<0.01)之间存在显著相关性。28名癌症幸存者回来使用他们冷冻保存的精子(9.33%),受精率为60.5%,着床率为29.6%。精子浓度与生育结果之间没有相关性。

结论

我们的结果证实了癌症对精子质量的负面影响,但不影响辅助生殖技术(ART)成功率,从男性生殖健康角度来看这极其重要。所有癌症患者都应接受咨询并提供生育力保存选择作为金标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f920/9297376/bfa1ac33920f/HSR2-5-e726-g001.jpg

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