Raw and Test Thaw Semen Parameters after Cryopreservation among Men with Newly Diagnosed Cancer

Capsule:
In cryopreserved semen from men with newly diagnosed cancer, all specimens show severe decline in postthaw total motile sperm count, with most severe reductions in the myeloid leukemia group.

Authors:
James M. Hotaling, M.D., M.S., Natalya A. Lopushnyan, M.D., Michael T. Davenport, B.A., Heather Christensen, B.S., Erin R. Pagel, B.S., Charles L. Muller, Ph.D., Thomas J. Walsh, M.D., M.S.

Volume 99, Issue 2, Pages 464-469.e2, February 2013

Abstract:

Objective:
To characterize sperm parameters from a thawed semen sample from men with different cancers who cryopreserved semen prior to oncologic therapy.

Design:
Retrospective cohort study

Setting:
Tertiary academic medical center.

Patients:
1,010 semen samples collected between 1994-2010.

Interventions:
None.

Main Outcome Measures:
Mean total motile count (TMC), change in percentage motility and percentage survival (100 * [postthaw % motility/raw % motility]) for each cancer compared with data from samples of men without cancer (the “procreative management” group), and proportion of postthaw samples with TMC >5 × 106.

Results:
The procreative management group had the best raw and postthaw semen quality. The best raw and postthaw semen quality for cancer patients occurred in those with prostate cancer (TMC of 155.1 and 53.2 × 106, respectively) and the worst in those with leukemias. Lymphoid leukemias demonstrated the worst raw TMC (26.8 × 106), but myeloid leukemias displayed the worst postthaw TMC (6.9 × 106). The testicular cancer group was the only group with a statistically significantly lower chance of having TMC >5 × 106.

Conclusions:
Men with testicular cancer were most commonly referred for sperm cryopreservation and were the only group that was statistically significantly less likely to have TMC >5 × 106 on postthaw semen analysis. The most severe reduction in TMC was seen in the myeloid leukemia group, suggesting that these patients along with men with testis cancer and those with lymphoid leukemia should be counseled to provide increased numbers of specimens for fertility preservation.

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