Fertility preservation by sperm banking before gonadotoxic treatment: 26 years of experience

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F21%3A00074947" target="_blank" >RIV/65269705:_____/21:00074947 - isvavai.cz</a>

Výsledek na webu

<a href="https://www.fertstert.org/article/S0015-0282(21)01174-2/fulltext#relatedArticles" target="_blank" >https://www.fertstert.org/article/S0015-0282(21)01174-2/fulltext#relatedArticles</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.fertnstert.2021.07.575" target="_blank" >10.1016/j.fertnstert.2021.07.575</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Fertility preservation by sperm banking before gonadotoxic treatment: 26 years of experience

Popis výsledku v původním jazyce

Objective Sperm banking before gonadotoxic treatment is the basic and most effective method of preserving reproduction, which can be used during adolescence. The communication summarizes 26 years of experience in the operation of an oncological sperm bank, analyzes spermiograms of oncological patients, assesses the relationship between sperm pathology and diagnosis, determines the number of deaths and the use of frozen sperm. Materials and Methods During the existence of CAR 01, more than 50,000 spermiograms were performed. From January 1995 to December 2020, 24,729 men were examined within the sperm bank, of which 1448 (5.9%) had an oncological diagnosis. Spermiograms were evaluated according to current WHO manuals. Cryopreservation of sperm has undergone a major development. The rules for the storage of frozen cells have been laid down since 2008 by Act No. 296/2008 Coll. In all cases, the standard thawing technique was used. Sperm were processed by the swim-up method. As part of treatment with assisted reproduction methods, oocytes were fertilized with the ICSI micromanipulation technique. Results Out of 1448 examined spermiograms in men with oncological diagnosis, testicular cancer was present in 43.7% of patients, malignant disease of lymphatic and hematopoietic tissue in 24.1%, of which Hodgkin&apos;s lymphoma 17.8%, non-Hodgkin&apos;s lymphoma 7.6 %. Leukemia was found in 7.9%, bone and cartilage cancers in 6.8%. The age of the clients of the whole group ranged from 13 to 64 years (27.2 +- 6.8 years). 38.3% of men had normozoospermia, 54.2% of spermiograms showed a pathological finding in 1 to 3 evaluated parameters and 7.5% of patients had azoospermia. Severe asthenozoospermia (mobility LESS-THAN OR EQUAL TO 10%) was detected in 57.2% of men and severe oligozoospermia (concentration LESS-THAN OR EQUAL TO 1 x 106 mm3) in 22.3% of patients. The lowest values of the spermiogram were found in men with testicular cancer, the best values were in CNS cancers. Cryopreservation of sperm was performed in 1340 cases (92.5%). So far, a total of 160 men (11.9%) have used frozen sperm, of which 6.2% in our centre. In these 83 cases, the ICSI technique was always used, 38 clinical pregnancies (45.8%) and 32 births were achieved. We have registered 424 completed storage of semen (31.6%), of which 148 due to death, ie. in 11.0% of all oncology patients, the others at their own request. A specific issue is the use of the sperm of the dead. Conclusions In cancer patients, sperm pathologies are in a high percentage. The lowest spermiogram values were found in men with testicular cancer. It is necessary to take into account long-term storage and fertilization by micromanipulation methods. The number of men who die is significantly higher than those who use sperm to treat infertility. Impact Statement Cryopreservation of sperm is very usefull method and should be offered to each patient prior to therapy potentialy leading to destruction of spermatogenesis.

Název v anglickém jazyce

Fertility preservation by sperm banking before gonadotoxic treatment: 26 years of experience

Popis výsledku anglicky

Objective Sperm banking before gonadotoxic treatment is the basic and most effective method of preserving reproduction, which can be used during adolescence. The communication summarizes 26 years of experience in the operation of an oncological sperm bank, analyzes spermiograms of oncological patients, assesses the relationship between sperm pathology and diagnosis, determines the number of deaths and the use of frozen sperm. Materials and Methods During the existence of CAR 01, more than 50,000 spermiograms were performed. From January 1995 to December 2020, 24,729 men were examined within the sperm bank, of which 1448 (5.9%) had an oncological diagnosis. Spermiograms were evaluated according to current WHO manuals. Cryopreservation of sperm has undergone a major development. The rules for the storage of frozen cells have been laid down since 2008 by Act No. 296/2008 Coll. In all cases, the standard thawing technique was used. Sperm were processed by the swim-up method. As part of treatment with assisted reproduction methods, oocytes were fertilized with the ICSI micromanipulation technique. Results Out of 1448 examined spermiograms in men with oncological diagnosis, testicular cancer was present in 43.7% of patients, malignant disease of lymphatic and hematopoietic tissue in 24.1%, of which Hodgkin&apos;s lymphoma 17.8%, non-Hodgkin&apos;s lymphoma 7.6 %. Leukemia was found in 7.9%, bone and cartilage cancers in 6.8%. The age of the clients of the whole group ranged from 13 to 64 years (27.2 +- 6.8 years). 38.3% of men had normozoospermia, 54.2% of spermiograms showed a pathological finding in 1 to 3 evaluated parameters and 7.5% of patients had azoospermia. Severe asthenozoospermia (mobility LESS-THAN OR EQUAL TO 10%) was detected in 57.2% of men and severe oligozoospermia (concentration LESS-THAN OR EQUAL TO 1 x 106 mm3) in 22.3% of patients. The lowest values of the spermiogram were found in men with testicular cancer, the best values were in CNS cancers. Cryopreservation of sperm was performed in 1340 cases (92.5%). So far, a total of 160 men (11.9%) have used frozen sperm, of which 6.2% in our centre. In these 83 cases, the ICSI technique was always used, 38 clinical pregnancies (45.8%) and 32 births were achieved. We have registered 424 completed storage of semen (31.6%), of which 148 due to death, ie. in 11.0% of all oncology patients, the others at their own request. A specific issue is the use of the sperm of the dead. Conclusions In cancer patients, sperm pathologies are in a high percentage. The lowest spermiogram values were found in men with testicular cancer. It is necessary to take into account long-term storage and fertilization by micromanipulation methods. The number of men who die is significantly higher than those who use sperm to treat infertility. Impact Statement Cryopreservation of sperm is very usefull method and should be offered to each patient prior to therapy potentialy leading to destruction of spermatogenesis.

Druh

O - Ostatní výsledky

CEP obor

—

OECD FORD obor

30214 - Obstetrics and gynaecology

Projekt

Výsledek vznikl pri realizaci vícero projektů. Více informací v záložce Projekty.

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)<br>I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů