Department of Obstetrics and Gynaecology, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada.
MD Program, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada.
BMJ Open. 2024 Aug 13;14(8):e088112. doi: 10.1136/bmjopen-2024-088112.
Many cancer treatments pose a threat to fertility for patients. Semen cryopreservation before cancer treatment is an effective method to preserve fertility. There are sparse long-term data on the usage of samples from Canadian oncology sperm banks.
A retrospective chart review of all oncology sperm banking samples at a Canadian academic fertility centre from 2001 to 2020 was conducted.
From 2001 to 2020, 4521 samples were banked by 2504 patients. The most frequent diagnoses among these patients were testicular cancer (29.5%) and lymphoma (26.9%). Of these patients, only 81 (3.2%) patients returned to use their samples with intrauterine insemination (IUI) or in vitro fertilisation (IVF) treatment and 62 (2.5%) patients transferred their samples to another clinic. The time between banking and return for usage of the sperm ranged from 1 to 131 months with a median of 18 months after banking. A total of 66 IVF cycles (104 embryo transfers) and 101 IUI cycles from 67 patients were reviewed. Of the 67 couples who used their samples, 53.7% achieved a clinical pregnancy. The clinical pregnancy rate was 6.6% per cycle for IUI and 30.8% per embryo transfer for IVF. Higher sperm concentration or total motile count was not associated with a higher chance of pregnancy. Patients who conceived had on average 1.9 ± 0.8 (p=0.02) more usable embryos per cycle than those who did not conceive.
Sperm cryopreservation provides a valuable option for patients with cancer to achieve parenthood after potentially gonadotoxic cancer treatment. However, the overall usage of banked oncology sperm samples is very low.
许多癌症治疗方法会对患者的生育能力造成威胁。癌症治疗前进行精液冷冻保存是保留生育能力的有效方法。加拿大肿瘤精子库的样本使用长期数据稀疏。
对加拿大一家学术生育中心 2001 年至 2020 年期间所有肿瘤精子库样本进行回顾性图表审查。
2001 年至 2020 年，共有 2504 名患者冷冻保存了 4521 份样本。这些患者中最常见的诊断是睾丸癌（29.5%）和淋巴瘤（26.9%）。在这些患者中，只有 81 名（3.2%）患者返回使用他们的样本进行宫腔内人工授精（IUI）或体外受精（IVF）治疗，62 名（2.5%）患者将样本转移到另一家诊所。从冷冻保存到使用精子的时间间隔为 1 至 131 个月，中位数为冷冻保存后 18 个月。对 67 名患者的 66 个 IVF 周期（104 个胚胎移植）和 101 个 IUI 周期进行了回顾。在使用样本的 67 对夫妇中，53.7%的夫妇实现了临床妊娠。IUI 的临床妊娠率为每周期 6.6%，IVF 的临床妊娠率为每胚胎转移 30.8%。较高的精子浓度或总运动计数与较高的妊娠机会无关。受孕的患者平均每个周期有 1.9±0.8 个（p=0.02）可用胚胎，而未受孕的患者平均每个周期有 1.9±0.8 个（p=0.02）可用胚胎。
精液冷冻保存为癌症患者提供了一种有价值的选择，可在潜在的性腺毒性癌症治疗后实现生育。然而，肿瘤精子库样本的总体使用量非常低。
