Sperm DNA fragmentation in men with malignancy

Capsule:
This observational study of sperm DNA fragmentation in men with malignancy presenting for semen cryopreservation compared with men presenting for sperm donation found no difference in sperm DNA fragmentation indices.

Authors:
Simon McDowell, Keith Harrison, M.Sc., Ben Kroon, C.R.E.I., Emily Ford, M.P.H., Anusch Yazdani, C.R.E.I.

Volume 99, Issue 7, Pages 1862-1866, June 2013

Abstract:

Objective:
To determine if men with malignancy have increased sperm DNA fragmentation compared with men presenting for sperm donation.

Design:
Retrospective observational study.

Setting:
Tertiary-level fertility center.

Patient(s):
Eighty-nine men with cancer presenting for prophylactic semen cryopreservation and 35 men presenting for sperm donation.

Intervention(s):
None.

Main Outcome Measure(s):
Sperm DNA fragmentation index (DFI) measured by sperm chromatin assay.

Result(s):
The mean sperm DFI in men with a diagnosis of cancer, 9.88% (95% confidence interval [CI] 7.84%–12.44%), did not differ from that found in men presenting for sperm donation 10.46% (95% CI 8.68%–11.80%). There were no significant differences in mean sperm DFI within cancer subgroups or when comparing testicular and nontesticular cancers. Subgroup analysis lacked statistical power. Men with testicular cancer have significantly reduced sperm concentration compared with both control subjects and men with nontesticular cancer.

Conclusion(s):
In our study population there was no difference in sperm DFI between men undergoing prophylactic semen cryopreservation and men presenting for sperm donation. Sperm DFI assessment has limited utility in the routine evaluation of men presenting for semen cryopreservation.

  • jim hotaling

    This is important work. To date we have no idea why men with male factor infertility are more likely to develop cancer and also do not know exactly why men with some cancers such as testis cancer, AML and Hodgkins often have very poor sperm counts at cancer presentation. This work investigates one important mechanism for the link between cancer and poor sperm quality, DNA fragmentation and find that there is no difference between men with cancer and those from sperm donors. One thing the authors might look at is how the cryopreservation process impacts sperm DNA fragmentation as some types of cancers, such as Testis Cancer, have poorer sperm recovery rates from cryopreservation than other cancers and this could be a reason.

  • Reassuring article that there is still a good possibility to obtain quality sperm prior to definitive oncologic therapy for cryopreservation. It is often difficult to arrange for cryo preservation for these patients given the tight schedule from time of diagnosis, pre op testing, and then surgery, radiation therapy, or chemotherapy so I applaud this group for having a relatively large cohort.

    It would be nice to have a follow up study with the patients from this cohort to see any were able to achieve pregnancy spontaneously after cancer therapy and if not, what was the success rates using the cryopreserved sperm for IVF/ICSI.

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