Bank Sperm Before Cancer Treatment
Men with sarcoma or carcinoma have poor semen quality even before receiving cancer therapy, and therapy will further impair semen quality. Whether or not men are cured of their cancer, induced infertility could greatly diminish their quality of life. Men diagnosed with cancer who want to perserve the possibility of having children should be offered sperm banking before therapy is initiated.
New research from the Cleveland Clinic's Urological lnstitute suggests that although cryopreservation damages sperm in men with sarcoma or carcinoma, it's post-thaw quality is still good enough to be useful in assisted reproduction, particularly in men with sarcoma.
Researchers obtained semen specimens from 21 men with carcinoma, 14 men with sarcoma and 50 healthy donors. As expected, the healthy donors had significantly higher prefreeze total motile sperm counts than did the cancer patients. They also had significantIy greater percent motility and percent linearity.
The specimens were cryopreserved by standard freezing procedures and then thawed. The men with cancer had significantly lower total motile sperm counts and significantly lower values for three measures of sperm motion (curvilinear velocity. linearity and amplitude of lateral head displacement).
Our findings suggest that despite its compromised quality, the semen of patients with sarcoma can be adequate for use in simple techniques such as intrauterine insemination, which, according to unpublished observations, appears to require a post-wash motility of at least 40%. On the other hand, the semen quality of carcinoma patients is so poor that they might require advanced assisted reproductive techniques, such as intracytoplasmic sperm injection, which requires only a single motile sperm for fertilization.
There appears to be much to gain and little to lose by offering sperm cryopreservation to men with sarcoma or carcinoma before they begin therapy for cancer.
American Center for Reproductive Medicine
The Cleveland Clinic
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Cleveland, OH 44195 USA
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