Genitourinary cancer patients have worse baseline semen parameters than healthy sperm bankers

Abstract

Background: While the spermatotoxic properties of cancer treatments such as chemotherapy and radiation therapy are widely recognized, the effect of malignancy itself on male fertility is not clearly understood. Objectives: To determine whether malignancy is associated with diminished semen quality prior to spermatotoxic treatment among sperm bankers. Materials and Methods: Retrospective database review of de-identified records was obtained for all episodes of sperm banking performed at a cryobank from January 2004 to May 2017 for one of the following reasons: 'future use' (e.g., military deployment and gender reassignment); infertility; benign disease; and malignancy, further categorized as testicular, other genitourinary (GU), solid non-GU, hematologic, or unspecified. Dependent variables of interest were ejaculatory volume, sperm concentration, % motility, and total motile sperm count (TMSC), as well as post-thaw TMSC. Results: A total of 1558 patients met the inclusion criteria. Multivariable regression analysis on log-transformed data controlling for age demonstrated decreased ejaculatory volume and sperm concentration, % motility, and TMSC in the infertility group as compared to the 'future use' group (p < 0.001). Testicular cancer was associated with decreased sperm concentration, TMSC, and postthaw TMSC (p < 0.001); other GU malignancy was associated with decreased ejaculatory volume (p < 0.001). Benign disease, solid non-GU malignancy, hematologic malignancy, and unspecified malignancy were not associated with decreased parameters. Discussion: In addition to sperm bankers with known fertility issues, sperm bankers with testicular and other GU malignancy had worse baseline semen parameters as compared to individuals pursuing banking for future use. These findings can inform patient counseling and consent prior to sperm banking and disease treatment. Conclusion: Individuals with testicular and other GU malignancy who banked spermatozoa before undergoing spermatotoxic therapy demonstrated worse baseline semen parameters as compared to individuals banking spermatozoa for non-medical reasons.

Association of malignant neoplasms with semen quality in Guangdong province, China: A propensity score matching analysis

“…To date, there are still controversies regarding the effects of malignant neoplasm itself on semen quality before clinical treatments. Consistent with most previous studies, we found that malignant neoplasm patients had significantly lower semen quality before specific antineoplastic treatments 5,12 . However, some studies did not observe reduced semen quality in malignant neoplasm patients before chemotherapy or radiation treatments.…”

“…The results of previous studies investigating the effects of malignant neoplasms on semen quality were somewhat inconsistent. Some studies found reductions in semen quality in malignant neoplasm patients including lower sperm count, motility, and/or normal forms, 4,5 while other studies did not observe any association between malignant neoplasms and semen quality 6–9 . The inconsistency may result from the lack of a comparable control group, which is critical in adequately assessing the effect of malignant neoplasms on semen quality.…”

SARS‐CoV‐2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services

“…Chemotherapy, radiotherapy, and radical surgical procedures might irreversibly impair spermatogenesis and/or ejaculation. Cancer itself can also affect fertility directly (eg, testicular cancer and Hodgkin's lymphoma) 8 . Currently, the only reliable method of fertility preservation in reproductive‐aged men with cancer is sperm banking 9 .…”

“…Cancer itself can also affect fertility directly (eg, testicular cancer and Hodgkin's lymphoma). 8 Currently, the only reliable method of fertility preservation in reproductive-aged men with cancer is sperm banking. 9 Sperm banking must be ideally completed before the start of gonadotoxic therapy.…”

Testicular germ cell cancer: recent developments in biology and clinical management

“…Two studies in this issue looked closely at the semen parameters in patients with TGCT. A large clinical study from a semen bank confirmed that TGCT patients had decreased sperm concentration and total motile sperm count even before treatment (Xu et al , ). Similar findings are reported in another translational study, which followed these observations by comparing the proteomic profiles of spermatozoa from testicular cancer patients with asthenozoospermia and normospermia, and found quantitative changes in several proteins involved in mitochondrial function, oxidative phosphorylation and fertilisation (Panner Selvam et al , ).…”