Outcomes of operative sperm retrieval strategies for fertility preservation among males scheduled to undergo cancer treatment

ObjectiveTo describe the outcomes of electroejaculation (EEJ) and testicular sperm extraction (TESE) performed for fertility preservation among male patients who are unable to ejaculate or have nonobstructive azoospermia/severe oligospermia before definitive cancer therapy.DesignRetrospective cohort study.SettingTertiary cancer referral center.Patient(s)Forty-nine patients seeking fertility preservation before definitive cancer therapy, with anejaculation, religious or cultural objections to masturbation, azoospermia, or severe oligospermia requiring either EEJ or TESE.Intervention(s)EEJ and TESE.Main Outcome Measure(s)Sperm retrieval rates.Result(s)Fifty-nine percent of patients overall and 60% of adolescents/young adults had sperm retrieved for cryopreservation. EEJ was successful in retrieving sperm in 60% of adolescents. Of all adolescents and young adults undergoing TESE, 33% had sperm retrieved for cryopreservation. No complications were reported. Chemotherapy was commenced without delay in all patients requiring it, frequently on the same day as the sperm retrieval.Conclusion(s)EEJ and TESE can be safely and successfully used for fertility preservation before cancer therapy among boys and young adult men who are unable to provide a semen specimen or have nonobstructive azoospermia, and they should be considered in all men meeting this patient profile.