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

Levi-Setti, Paolo Emanuele; Negri, L; Baggiani, A; Morenghi, Emanuela; Albani, Elena; Dioguardi, Carola Conca; Specchia, Cristina; Patrizio, Pasquale

doi:10.1007/s10815-020-01697-7

Cited by 10 publications

(4 citation statements)

References 42 publications

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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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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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“…In these cases of nonobstructive azoospermia, testicular sperm extraction via microdissection can yield sperm for IVF with ICSI. Single center experiences report successful surgical sperm retrieval rates of 37%–44% per patient and live birth rate of 40%–59% per couple 89,90 . Thus, a finding of azoospermia warrants a referral to reproductive urologists for the possibility of surgical sperm extraction to use autologous gametes.…”

Section: Post‐treatment Considerationsmentioning

confidence: 99%

Fertility preservation before and after cancer treatment in children, adolescents, and young adults

Yang,

Strohl,

2023

Cancer

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Fertility is a top concern for many survivors of cancer diagnosed as children, adolescents and young adults (CAYA). Fertility preservation (FP) treatments are effective, evidence‐based interventions to support their family building goals. Fertility discussions are a part of quality oncology care throughout the cancer care continuum. For nearly 2 decades, clinical guidelines recommend counseling patients about the possibility of infertility promptly at diagnosis and offering FP options and referrals as indicated. Multiple guidelines now recommend post‐treatment counseling. Infertility risks differ by cancer treatments and age, rendering risk stratification a central part of FP care. To support FP decision‐making, online tools for female risk estimation are available. At diagnosis, females can engage in mature oocyte/embryo cryopreservation, ovarian tissue cryopreservation, ovarian suppression with GnRH agonists, in vitro oocyte maturation, and/or conservative management for gynecologic cancers. Post‐treatment, several populations may consider undergoing oocyte/embryo cryopreservation. Male survivors’ standard of care FP treatments center on sperm cryopreservation before cancer treatment and do not have the same post‐treatment indication for additional gamete cryopreservation. In practice, FP care requires systemized processes to routinely screen for FP needs, bridge oncology referrals to fertility, offer timely fertility consultations and access to FP treatments, and support financial navigation. Sixteen US states passed laws requiring health insurers to provide insurance benefits for FP treatments, but variation among the laws and downstream implementation are barriers to accessing FP treatments. To preserve the reproductive futures of CAYA survivors, research is needed to improve risk stratification, FP options, and delivery of FP care.

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“… 20 When completed by intracytoplasmatic sperm injection (ICSI), live birth rates following TESE in cancer patients are 40% per couple per single ovarian hyperstimulation. 21 Therefore, in the event of azoospermia or if sperm banking is not possible, testicular tissue cryopreservation for TESE can be an effective FP option. 21 …”

Section: Introductionmentioning

confidence: 99%

“… 21 Therefore, in the event of azoospermia or if sperm banking is not possible, testicular tissue cryopreservation for TESE can be an effective FP option. 21 …”

Section: Introductionmentioning

confidence: 99%

An Assessment of Cryopreserved Semen and Testicular Tissue Collected Before and After Cancer Treatment Initiation

Fernández-González,

Radauer-Plank,

Borgmann-Staudt

et al. 2024

CMAR

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Purpose This retrospective cohort study assessed semen and testicular tissue quality from adult and adolescent cancer patients who had samples cryopreserved in the Cryobank of Charité-Universitätsmedizin before and/or after cancer treatment. Methods and Materials Medical and cryopreservation data for all samples stored between 03/2004 and 05/2019 were collected retrospectively. Results We included information on 601 samples cryopreserved from 506 cancer patients for whom oncologic treatment data were available. The majority of the samples were cryopreserved prior to cancer treatment (460/600, 77%, median 5 days before treatment). Semen quality had a predisposed reduction in those collected from adolescents with testicular and/or hematological malignancies. Analyses of the 140 (23%) samples cryopreserved after treatment initiation (median of 84 days) revealed decreased median concentration and motility following high gonadotoxic-risk treatment. Rate of oligoasthenozoospermia was comparable in samples collected prior to treatment with those provided during follow-up spermiograms within 1 year after treatment initiation (45.5% vs 45.5%). However, an increase was seen in samples collected 1–2 (9.1% to 90.9%) and 2–3 (50.0% to 100.0%) years after treatment initiation. Conclusion Cancer diagnosis and treatment may impair spermatogenesis; therefore, patient counseling prior to cancer treatment by an oncologist and/or fertility specialist is crucial.

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

Cited by 10 publications

References 42 publications

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

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

Fertility preservation before and after cancer treatment in children, adolescents, and young adults

An Assessment of Cryopreserved Semen and Testicular Tissue Collected Before and After Cancer Treatment Initiation

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