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Title: Cryo Sperm Preservation Underused in Men With Cancer: Presented at ASRM

"Cryo Sperm Preservation Underused in Men With Cancer: Presented at ASRM"

By Robert H. Carlson SAN ANTONIO, TX -- October 23, 2003 -- Although cancer treatment is known to cause infertility in men and women, few men are cryopreserving their sperm before the chemotherapy or radiation treatments begin. Furthermore, sperm stored by these patients often goes unused. "Sperm cryostorage for fertility preservation in male cancer patients is underutilised, and there is minimal use of specimens for reproductive purposes," said Karine Chung, MD, a fellow in the Program for Male Fertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States. At the 59th Annual Meeting of the American Society for Reproductive Medicine here, Dr. Chung said she gathered her epidemiological data to aid physicians who counsel men with cancer. "It is disturbing to report that 20% of patients are not referred [to a fertility lab] until after undergoing at least one cycle of chemotherapy or radiotherapy," Dr. Chung said. Looking at 10-year data on 164 oncology patients, mean age of the men in the study was 29.5 years, ranging from 13 to 58 years, who chose to freeze sperm at her institution, Dr. Chung found that 20 of them did so only after receiving one or more cycles of chemotherapy. "There is a dilemma of whether to freeze specimens at all from these patients," she said, given the potential chromosomal aberrations in the sperm caused by the cancer treatments that could result in birth defects. Dr. Chung also found that only 6 of the 164 specimens were later used for reproductive purposes. Only two resulted in successful impregnations. Thirteen of the men died so storage was discontinued. Another finding was that men with cancer could already be on their way to infertility due to the effects of the disease alone, Dr. Chung said. "Oligospermia was common, even in the absence of chemo- or radiotherapy," she said. Low pre-treatment sperm counts were seen in 28% of the men with testicular cancer, 25% of those with Hodgkin's disease, 57% of leukaemia patients and 33% of those with gastrointestinal cancer. Session co-moderator Harris M. Nagler, MD, commented that the problem does not seem to be the underuse of cryopreservation as much as underuse of the cryopreserved sperm, and he recommended this as an area for further investigation. [Study title: Sperm Cryopreservation for Male Patients With Cancer: An Epidemiological Analysis. Abstract O-298]

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