Introduction

It is suggested that semen quality is already impaired in testicular cancer (TC) patients. However, the impact of type of malignancy on semen quality remains unclear. The aim of this study is to investigate the semen parameters and associated malignancies of men with cancer who cryopreserved sperm before undergoing therapy.

Methods

We reviewed the database from our cryopreservation laboratory between January 1994 and May 2016, and identified 114 patients who have banked their sperm before undergoing treatment. Age at banking, semen volume, sperm density, percent motile sperm and type of cancer were recorded. Semen parameters were compared between TC and other malignancy (non-TC).

Results

A total of 114 semen samples included 25% with testicular cancer (seminoma: 8.8% and non-seminoma: 17%), 25% with lymphoma, 18% with leukemia, 7.0% with myelodysplastic syndrome, 4.4% with solid cancer, 3.5% with urological cancer, 1.8% with immune system diseases, and unspecified 13%. Median patient age, semen volume, sperm density and sperm motility were 29 years, 2.9 mL, 28 x 106/mL, and 43%, respectively. Patients with TC had significantly lower total sperm concentration (P=0.008) and motile sperm rate (P=0.012) compared with other malignancies. The fertile range of the sperm from cancer patients were significantly poor in the TC (fertile 0%, intermediate 31%, and subfertile 69%) compared with other malignancies (12%, 42%, and 46%, respectively) (P=0.044). In TC patients, the ratio of oligozoospermia was significantly higher in comparison with other malignancies (P<0.001). There were no significant differences in sperm parameters between seminoma and non-seminoma, whereas ratio of oligozoospermia was significantly greater in non-seminoma group than seminoma group (P<0.001). Among 29 TC patients, 3 patients (10%) had undergone infertility treatment, and 2 patients (7%) archived pregnancy and resulted in 2 deliveries.

Conclusions

Men with testicular cancer have lower semen quality compared to those with other malignancies. The rate of using cryo-thawed sperm from cancer patients for fertility treatments in our unit was 10%.

Funding

none