Semen cryobanking for men with cancer--criteria change

Abstract

Objective: To summarize pregnancies and births after the use of pretherapy cryobanked semen from men with cancer and to reassess the clinical role of semen cryobanking for these patients.

Design: Survey of pregnancies and births that have occurred after the use of cryobanked semen from pretherapy cancer patients.

Setting: Survey of the literature and of nine semen banks.

Patients: Men with testicular cancer, Hodgkin's diseases, non-Hodgkin's lymphoma, and other types of cancer who cryobanked their semen specimens before therapy.

Outcome measures: Pregnancies and births resulting from the use of cryobanked semen after artificial insemination by husband (AIH) or other assisted reproductive technology (ART) procedures.

Results: The use of AIH and other ART procedures have resulted in 117 documented pregnancies and 115 livebirths.

Conclusions: Cryobanking of semen should be offered to all men diagnosed with cancer because such a procedure provides the only reasonable chance of establishing a pregnancy after therapy that is detrimental to fertility potential. Existing criteria for pretherapy semen cryobanking, therefore, should be revised in view of successful pregnancies even with the use of semen with low spermatozoal densities and motilities, as well as other realized clinical efficacies of ART. Conceptions have occurred after in vitro fertilization (IVF) with < 1 x 10(6) motile spermatozoa. Semen cryobanking should be offered by the attending physician as a viable option for any pretherapy male patient who has any motile sperm and considers the future possibility of having children.