Sperm cryopreservation before cancer treatment: a 15-year monocentric experience

Sperm banking is an important procedure to preserve fertility before cancer therapy. The aim of this study was to comprehensively analyse cryopreservation activity retrospectively for 1080 patients referred to the sperm bank for sperm cryopreservation before cancer treatment. This study included 1007 patients diagnosed with testicular cancer (TC) (41.7%), lymphoma (26%), other haematological cancers (9.4%) or other types of cancer (22.8%); of these, 29 patients did not produce any semen sample and cryopreservation was impossible for 67 patients. Semen characteristics before treatment were within normal ranges, except moderate asthenospermia. Sperm concentration was significantly lower in TC than in non-TC. Straws from 57 patients (6.3%) were used in assisted reproductive technologies, which led to a 46.8% cumulative birth rate. Straws were destroyed for 170 patients (18.7%) and 140 patients performed semen analyses after cancer therapy. After an average delay of 22.5 months after the end of therapy, 43 patients (30.7%) exhibited azoospermia. This study of a large population of cancer patients revealed a high level of successful sperm storage. Utilization of cryopreserved spermatozoa led to good chances of fatherhood. Nevertheless, sperm banks should be aware of the low rates of straw use and straw destruction by cancer patients.Sperm banking is an important procedure to preserve fertility before cancer therapy. The aim of this study was to analyse comprehensive cryopreservation activity. We retrospectively studied 1080 patients referred to the sperm bank for sperm cryopreservation before cancer treatment. We included 1007 patients diagnosed with testicular cancer (TC) (41.7%), lymphoma (26.0%), other haematological cancers (9.4%) or other types of cancer (22.8%). Of these, 29 patients did not produce any semen sample and cryopreservation was impossible for 67 patients. Semen characteristics before treatment were within normal ranges, except moderate decrease in sperm motility. Sperm concentration was significantly lower in TC than in non-TC. Frozen spermatozoa from 57 patients (6.3%) were used in assisted reproductive treatment, which led to a 46.8% cumulative birth rate. Frozen spermatozoa were destroyed for 170 patients (18.7%). A total of 140 patients performed semen analyses after cancer therapy. After an average delay after the end of therapy of 22.5 months, 43 patients (30.7%) exhibited an absence of spermatozoa in the semen. This study of a large population of cancer patients revealed a high level of successful sperm storage. Utilization of cryopreserved spermatozoa in assisted reproduction led to good chances of fatherhood. Nevertheless, sperm banks should be aware of the low rates of frozen sperm use and frozen sperm destruction by cancer patients.