Testicular Sperm Extraction and ICSI in Patients with Post-Chemotherapy Non-Obstructive Azoospermia

Hibi, Hatsuki; Yamada, Yoshiaki; Honda, N.; Hashiba, Yoshiki; Asada, Yoshimasa

doi:10.1080/01485010600915152

Cited by 12 publications

(5 citation statements)

References 13 publications

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“…In our study, we have shown that half of the men (50.7%) unable to cryopreserve sperm prior to cancer treatment and diagnosed with permanent azoospermia had successful sperm retrieved with TESE and usable for at least one ICSI cycle, a rate similar to the control group. Our data is in line with the results of previous reports (from a total of 258 patients and 283 surgical retrievals, the rate of sperm recovery was 45.9%) [36][37][38][39][40][41][42][43] and also confirm that not all forms of cancer benefit from successful sperm recovery [39].…”

Section: Discussionsupporting

confidence: 92%

“…Cumulative live birth rates per couple in NOA cancer survivors did not differ from non-cancer NOA patients (40 vs. 46.5%), despite the significantly older age of the female partners in cancer survivors. However, compared with data in literature (60 deliveries out of 122 couples = 49.2%) [36][37][38][39][40][41][42][43], we showed a lower live birth rate, and this might reflect the mean older age of the female partners in our dataset [44]. The rate of first trimester (< 12 weeks) miscarriage were higher in both NOA and RE/FOE cancer survivors, than in the non-oncologic controls.…”

Section: Discussionsupporting

confidence: 54%

“…The limitations of our study are the retrospective design and the relatively low number of patients treated; however, it represents one of the largest case histories for infertile cancer survivors who did not bank sperm ahead of their oncological treatment [36][37][38][39][40][41][42][43]. Another limitation of our study is that ICSI outcome results might have been hampered by Italian Law 40 that banned cryopreservation of embryos during the 2004-2009 period [24].…”

Section: Discussionmentioning

confidence: 99%

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Testicular sperm extraction and intracytoplasmic sperm injection outcome in cancer survivors with no available cryopreserved sperm

Levi-Setti

Negri

Baggiani

et al. 2020

J Assist Reprod Genet

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Objective To assess rates of successful testicular sperm retrieval and intracytoplasmic sperm injection (ICSI) outcome in cancer survivors affected by non-obstructive azoospermia (NOA) or retrograde ejaculation (RE)/failure of emission (FOE). Methods A retrospective analysis of cancer survivors who did not cryopreserve sperm prior to treatment undergoing testicular sperm extraction (TESE). Non-cancer NOA patients and neurologic RE/FOE were the control group. Results A total of 97 cancer survivors were offered TESE and 88 (91%) accepted. Sperm was retrieved and cryopreserved in 34/ 67 patients with NOA (50.7%) and in 21/21 patients affected by RE/FOE (100%). Sperm retrieval rates were similar in the control group (44.9% in NOA and 100% in RE/FOE). The ICSI cumulative pregnancy rate (60%) and live birth rate (40%) per couple in 30 NOA men did not differ from controls (50.0 and 46.5%, respectively; p = 0.399/0.670). The cumulative pregnancy rate (66.7%) and live birth rate (55.6%) in 18 RE/FOE men did not differ from the control group (38.9 and 33.3%, respectively; p = 0.181/0.315). The cancer type and the resulting infertility disorder (NOA or RE/FOE) were not associated with ICSI outcomes. Female partner age was inversely related to the cumulative live birth rate, being fourfold lower (11.5%) in women ≥ 40 years and 48.8% in younger women (p = 0.0037). Conclusions The rate of successful TESE and the ICSI outcome in cancer survivors with NOA and RE/FOE is the same as noncancer azoospermic patients. Female partner age (older than 40 years) was associated with a significant reduction in live birth rates after TESE-ICSI procedures.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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Testicular sperm extraction and intracytoplasmic sperm injection outcome in cancer survivors with no available cryopreserved sperm

Levi-Setti

Negri

Baggiani

et al. 2020

J Assist Reprod Genet

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“…Eleven retrospective studies 26 29 30 31 32 33 34 35 36 37 38 and 8 case reports or case series 39 40 41 42 43 44 45 46 reported results for postgonadotoxic treatment TESE. The case reports and case series mainly reported TESEs that allowed for spermatozoa retrieval, while the retrospective studies reported between 33.3% and 76.2% positive TESEs ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

Testicular sperm extraction (TESE) outcomes in the context of malignant disease: a systematic review

Dupont¹,

Ogouma²,

Berthaut³

et al. 2022

Asian Journal of Andrology

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Advances in the oncology field have led to improved survival rates. Consequently, quality of life after remission is anticipated, which includes the possibility to conceive children. Since cancer treatments are potentially gonadotoxic, fertility preservation must be proposed. Male fertility preservation is mainly based on ejaculated sperm cryopreservation. When this is not possible, testicular sperm extraction (TESE) may be planned. To identify situations in which TESE has been beneficial, a systematic review was conducted. The search was carried out on the PubMed, Scopus, Google Scholar, and CISMeF databases from 1 January 2000 to 19 March 2020. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were followed in selecting items of interest. Thirty-four articles were included in the systematic review, including 15 articles on oncological testicular sperm extraction (oncoTESE), 18 articles on postgonadotoxic treatment TESE and 1 article on both oncoTESE and postgonadotoxic treatment TESE. Testicular sperm freezing was possible for 42.9% to 57.7% of patients before gonadotoxic treatment and for 32.4% to 75.5% of patients after gonadotoxic treatment, depending on the type of malignant disease. Although no formal conclusion could be drawn about the chances to obtain sperm in specific situations, our results suggest that TESE can be proposed before and after gonadotoxic treatment. Before treatment, TESE is more often proposed for men with testicular cancer presenting with azoospermia since TESE can be performed simultaneously with tumor removal or orchiectomy. After chemotherapy, TESE may be planned if the patient presents with persistent azoospermia.

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“…Studies on testicular stem cell transplantation are not available as yet. If no sperm was frozen before treatment, testicular sperm extraction (TESE) followed by ICSI can still offer a chance at fatherhood for patients with post-chemotherapy azoospermia [37,38].…”

Section: Semen Cryopreservationmentioning

confidence: 99%

Fertility preservation after chemotherapy for Hodgkin lymphoma

Kaaij¹,

Echten-Arends²,

Simons³

et al. 2010

Hematological Oncology

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Treatment for Hodgkin lymphoma can negatively affect fertility. This review summarizes data on fertility after chemotherapy in adult patients. Alkylating chemotherapy, especially if containing procarbazine and/or cyclophosphamide, is most harmful to gonadal functioning. Alkylating regimens cause prolonged azoospermia in 90-100% of men and ovarian failure in 5-25% of women under the age of 30. Non-alkylating chemotherapy, like ABVD, is much less harmful: one-third of male patients develop transient azoospermia, and almost no female patients experience ovarian failure. Age is an important factor for women: females over 30 years have a much higher risk of acute ovarian failure. However, with long-term follow-up the cumulative risk of menopause before the age of 40 becomes the same irrespective of treatment age. In males, semen cryopreservation before start of treatment should be offered to all (post)pubertal patients. For females with a partner, IVF followed by embryo cryopreservation is a widely available method, but this necessitates postponement of lymphoma therapy for at least a month. Oocyte cryopreservation and ovarian tissue cryopreservation are experimental techniques showing great promise. GnRH-analogues are being investigated as possible means to preserve fertility in women, but effectiveness has not yet been proven conclusively.

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Testicular Sperm Extraction and ICSI in Patients with Post-Chemotherapy Non-Obstructive Azoospermia

Cited by 12 publications

References 13 publications

Testicular sperm extraction and intracytoplasmic sperm injection outcome in cancer survivors with no available cryopreserved sperm

Testicular sperm extraction and intracytoplasmic sperm injection outcome in cancer survivors with no available cryopreserved sperm

Testicular sperm extraction (TESE) outcomes in the context of malignant disease: a systematic review

Fertility preservation after chemotherapy for Hodgkin lymphoma

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