Hallak J, Hendin B N, Thomas A J, Agarwal A
Andrology Research and Clinical Laboratories, Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA.
J Urol. 1998 Apr;159(4):1217-20.
There are few published reports concerning fertilization and pregnancy outcomes achieved with cryopreserved spermatozoa from cancer patients. Controversy exists regarding the value of sperm banking for these patients before therapy, whether the spermatozoa are viable after long-term storage and whether they can fertilize the ovum. We assess fertilization and pregnancy outcomes achieved with cryopreserved spermatozoa from cancer patients using assisted reproductive techniques.
We studied 10 cancer patients who transferred cryopreserved semen specimens from our sperm bank to outside in vitro fertilization programs for assisted reproductive technique. Of these patients 5 had Hodgkin's disease, 2 testicular cancer, 1 leukemia and 2 prostate cancer. The length of specimen storage ranged from 14 to 135 months (median 49, interquartile range 24 and 82).
The median pre-freeze motility was 44% (interquartile range 36 and 55%) and the median total sperm count was 31.1 x 10(6) (interquartile range 6.3 and 53.9 x 10(6)). At 24 hours after banking the median post-thaw motility was 11% (interquartile range 6 and 35%) and the median total sperm count was 6.6 x 10(6) (1.2 and 17.1 x 10(6)). A total of 18 cycles of assisted reproductive technique were performed among 10 couples with an overall pregnancy rate of 50% per couple, with 2 deliveries, 1 ongoing pregnancy and 2 miscarriages. The pregnancy rate per cycle of in vitro fertilization and intracytoplasmic sperm injection was 36.4% with an implantation rate of 13%.
These results indicate that poor quality cryopreserved spermatozoa from cancer patients, irrespective of the length of storage, may provide successful results with the latest micromanipulative techniques such as intracytoplasmic sperm injection.
关于癌症患者冷冻保存精子的受精及妊娠结局，已发表的报告较少。对于这些患者在治疗前进行精子库储存的价值、精子长期储存后是否仍具活力以及能否使卵子受精，存在争议。我们使用辅助生殖技术评估癌症患者冷冻保存精子的受精及妊娠结局。
我们研究了10名癌症患者，他们将从我们精子库冷冻保存的精液标本转至外部体外受精项目以进行辅助生殖技术。这些患者中，5例患有霍奇金淋巴瘤，2例患有睾丸癌，1例患有白血病，2例患有前列腺癌。标本储存时间为14至135个月（中位数49个月，四分位间距为24至82个月）。
冷冻前精子活力中位数为44%（四分位间距为36%至55%），精子总数中位数为31.1×10⁶（四分位间距为6.3×10⁶至53.9×10⁶）。储存后24小时，解冻后精子活力中位数为11%（四分位间距为6%至35%），精子总数中位数为6.6×10⁶（1.2×10⁶至17.1×10⁶）。10对夫妇共进行了18个辅助生殖技术周期，每对夫妇的总体妊娠率为50%，其中2例分娩，1例持续妊娠，2例流产。体外受精和卵胞浆内单精子注射每个周期的妊娠率为36.4%，着床率为13%。
这些结果表明，癌症患者质量较差的冷冻保存精子，无论储存时间长短，采用最新的显微操作技术如卵胞浆内单精子注射，可能会获得成功的结果。
