Weibring Kristina, Lundberg Frida E, Cohn-Cedermark Gabriella, Rodriguez-Wallberg Kenny A
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Department of Oncology, Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden.
J Adolesc Young Adult Oncol. 2025 Feb;14(1):68-76. doi: 10.1089/jayao.2024.0068. Epub 2024 Jul 29.
To investigate the quality of emergency-collected semen samples aimed at sperm cryopreservation provided by adolescents and young adults (AYAs) presenting with cancer or nonmalignant diseases. This is a prospective cohort study of postpubertal males referred for sperm cryopreservation who provided at least one semen sample for fertility preservation at the Reproductive Medicine Clinic of Karolinska University Hospital, Stockholm, Sweden, between January 2009 and January 2020. Sperm quality was assessed by total sperm count, concentration, and motility. Sperm quality by disease groups was compared with the reference population data of fertile men defined by the World Health Organization (WHO). Among the 1252 patients who provided samples for cryopreservation, 1063 had cancer and 189 had nonmalignant diseases. The most common malignant indications included testicular cancers ( = 501) and Hodgkin lymphoma ( = 102). Among those with nonmalignant disease, 35% ( = 66) had testicular disease. Sperm quality was significantly lower in all groups of patients with cancer compared with the reference population. In total, azoospermia was found in 8% of the patients with cancer, in 9% of those with nonmalignant testicular disease, and in 3% of the remaining men with nonmalignant disease. Sperm quality in adult patients with cancer was significantly impaired compared with the WHO reference population standards for fertile men. For adolescent patients, standard reference values are lacking. AYAs wishing to preserve fertility should receive individualized counseling regarding sperm quality at the time of cryopreservation, and in selected cases, banking of additional samples should be recommended depending on the sperm quality parameters.
调查患有癌症或非恶性疾病的青少年和青年（AYAs）为精子冷冻保存而紧急采集的精液样本质量。这是一项前瞻性队列研究，研究对象为青春期后因精子冷冻保存而转诊的男性，他们于2009年1月至2020年1月期间在瑞典斯德哥尔摩卡罗林斯卡大学医院生殖医学诊所提供了至少一份用于生育力保存的精液样本。通过精子总数、浓度和活力评估精子质量。将疾病组的精子质量与世界卫生组织（WHO）定义的生育男性参考人群数据进行比较。在提供冷冻保存样本的1252名患者中，1063人患有癌症，189人患有非恶性疾病。最常见的恶性指征包括睾丸癌（n = 501）和霍奇金淋巴瘤（n = 102）。在患有非恶性疾病的患者中，35%（n = 66）患有睾丸疾病。与参考人群相比，所有癌症患者组的精子质量均显著较低。总体而言，8%的癌症患者、9%的非恶性睾丸疾病患者和3%的其余非恶性疾病男性出现无精子症。与WHO生育男性参考人群标准相比，成年癌症患者的精子质量明显受损。对于青少年患者，缺乏标准参考值。希望保存生育力的AYAs在冷冻保存时应接受关于精子质量的个性化咨询，在某些情况下，应根据精子质量参数建议储存额外的样本。
