Outcomes of operative sperm retrieval strategies for fertility preservation among males scheduled to undergo cancer treatment

Capsule:
Electroejaculation and testicular sperm extraction led to successful sperm retrieval in 60% of adolescents and teenagers and 59% of adult men seeking fertility preservation before cancer therapy.

Authors:
Boback M. Berookhim, M.D., M.B.A., John P. Mulhall, M.D., M.Sc., F.E.C.S.M.

Volume 101, Issue 3, Pages 805-811, March 2014

Abstract:

Objective:
To describe the outcomes of electroejaculation (EEJ) and testicular sperm extraction (TESE) performed for fertility preservation among male patients who are unable to ejaculate or have nonobstructive azoospermia/severe oligospermia before definitive cancer therapy.

Design:
Retrospective cohort study.

Setting:
Tertiary cancer referral center.

Patient(s):
Forty-nine patients seeking fertility preservation before definitive cancer therapy, with anejaculation, religious or cultural objections to masturbation, azoospermia, or severe oligospermia requiring either EEJ or TESE.

Intervention(s):
EEJ and TESE.

Main Outcome Measure(s):
Sperm retrieval rates.

Result(s):
Fifty-nine percent of patients overall and 60% of adolescents/young adults had sperm retrieved for cryopreservation. EEJ was successful in retrieving sperm in 60% of adolescents. Of all adolescents and young adults undergoing TESE, 33% had sperm retrieved for cryopreservation. No complications were reported. Chemotherapy was commenced without delay in all patients requiring it, frequently on the same day as the sperm retrieval.

Conclusion(s):
EEJ and TESE can be safely and successfully used for fertility preservation before cancer therapy among boys and young adult men who are unable to provide a semen specimen or have nonobstructive azoospermia, and they should be considered in all men meeting this patient profile.

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