Fertility of testicular cancer patients after anticancer treatment - experience of 11 years

• Published in: Pharmazie Vol. 69; no. 6; pp. 437 - 441
• Main Authors: Molnár, Z, Berta, E, Benyó, M, Póka, R, Kassai, Z, Flaskó, T, Jakab, A, Bodor, M
• Format: Journal Article
• Language: English
• Published: Germany Govi-Verlag 01.06.2014
• Subjects: Adolescent; Adult; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Combined Modality Therapy; Cryopreservation; Disease Progression; Female; Fertility - physiology; Fertilization in Vitro; Follow-Up Studies; Humans; Male; Middle Aged; Orchiectomy; Pregnancy; Pregnancy Rate; Retrospective Studies; Seminoma - complications; Seminoma - pathology; Seminoma - therapy; Sperm Banks; Spermatozoa - chemistry; Spermatozoa - drug effects; Surveys and Questionnaires; Testicular Neoplasms - complications; Testicular Neoplasms - pathology; Testicular Neoplasms - therapy; Young Adult
• ISSN: 0031-7144
• DOI: 10.1691/ph.2014.3912R

Testicular cancer affects men mostly in their reproductive age with a cure rate over 90%. Preserved fertility is one of the main concerns of the survivors. To further elucidate the question of fertility after anticancer treatment for testicular cancer, we performed a survey among patients who underwent sperm cryopreservation procedure in our department. A structured questionnaire was designed to collect data on demography, anticancer treatment, histological type of cancer, family planning intentions and fertility prior to and after treatment. During a period of 11 years 86 men underwent semen cryopreservation before starting chemoor radiotherapy. Fifty-nine of them consented to participate in the study. The average length of follow up was 4.6 ± 3.8 years. In case of 11.9% of the patients their banked sperm was used, which led to live birth in 57% of the couples. The partners of 6 patients became pregnant after in vitro fertilization (IVF) resulting in 4 live births and 2 miscarriages. The spontaneous pregnancy rate was 22%. Spontaneous pregnancy occurred in 13 partners resulting in 18 pregnancies followed by 12 live births, 2 artificial abortions and 4 miscarriages. We could not prove any association between preserved fertility and anticancer treatment or the histological type of the cancer. In conclusion, although spontaneous pregnancy rate is remarkably high after anticancer treatment for testicular cancer, the risk of infertility after receiving gonadotoxic treatment cannot be predicted. Cryopreservation is a safe and effective method to preserve fertility in these cases. As a result we strongly recommend discussing the advantages of semen cryopreservation with all patients awaiting treatment for testicular cancer.