The outcome of IVF/ICSI cycles in male cancer patients: retrospective analysis of procedures from 2004 to 2018

Abstract

IntroductionFertility preservation is an important aspect of quality of life in oncological patients, and in men is achieved by semen cryopreservation prior to treatment. Results of in vitro fertilization (IVF) procedures in healthy infertile couples are comparable, regardless of whether fresh or cryopreserved semen is used, but are scarce in male oncological patients.Patients and methodsWe performed a retrospective analysis of IVF/intracytoplasmic sperm injection (IVF/ICSI) procedures in infertile couples where men had been treated for cancer in the past. We additionally compared the results of IVF/ICSI procedures with respect to the type of semen used (fresh, cryopreserved).ResultsWe compared the success rates of 214 IVF/ICSI cycles performed in the years 2004–2018. Pregnancy (30.0% vs. 21.4%; p = 0.12) and live-birth rates (22.3% vs. 17.9%; p = 0.43) per oocyte aspiration were similar between the groups in fresh cycles; however embryo utilization (48.9% vs. 40.0%; p = 0.006) and embryo cryopreservation rates (17.3% vs. 12.7%; p = 0.048) were significantly higher in the cryopreserved semen group. The cumulative pregnancy rate (60.6% vs. 37.7%; p = 0.012) was significantly higher, and the live-birth rate (45.1% vs. 34.0%; p = 0.21) non-significantly higher, in the cryopreserved semen group.ConclusionsThe success of IVF/ICSI procedures in couples where the male partner was treated for cancer in the past are the same in terms of pregnancies and live-births in fresh cycles regardless of the type of semen used. However, embryo utilization and embryo cryopreservation rates are significantly higher when cryopreserved semen is used, leading to a significantly higher cumulative number of couples who achieved at least one pregnancy.

Impact of cancer on cryopreserved sperm quality and fertility: A cohort study

“…The pregnancy rates and live birth rates were similar in the two groups. 16 In our study, we did not observe any correlation between the frozen sperm concentration and fertility outcomes. These results are important to promote sperm cryopreservation before oncological treatment and should be discussed during fertility preservation counselling.…”

“…Finally, a 2021 study compared thawed sperm versus fresh sperm used for IVF/ICSI in cancer patients. The pregnancy rates and live birth rates were similar in the two groups 16 . In our study, we did not observe any correlation between the frozen sperm concentration and fertility outcomes.…”

“…13,14 Previous studies showed sperm quality impairment before the gonadotoxic treatment due to cancer itself, 10 focusing mainly on the testicular cancers and hematologic malignancies. 9,11 Few authors evaluated the fertility outcomes, [15][16][17] emphasizing the importance of the use of frozen sperm for male cancer patients.…”

An evaluation of the population characteristics, semen quality, and utilization status of autologous sperm cryopreservation and fertility preservation in for 662 patients: a 6-year monocentric retrospective study

“…It has also been suggested that ICSI may optimize the chances of pregnancy, regardless of the fertility status of the female partner, given the decreased quality of the frozen-thawed test for semen frozen over a long period of time [ 21 , 25 ]. Clinical pregnancy rates for ART cycles ranged from 45.8% to 82% while live birth rates ranged from 35 to 82%, thus demonstrating the achievement of fertility and safe pregnancies with frozen-thawed sperm [ 36 ]. Depalo et al .…”

“…It has also been suggested that ICSI may optimize the chances of pregnancy, regardless of the fertility status of the female partner, given the decreased quality of the frozen-thawed test for semen frozen over a long period of time [21,25]. Clinical pregnancy rates for ART cycles ranged from 45.8% to 82% while live birth rates ranged from 35 to 82%, thus demonstrating the achievement of fertility and safe pregnancies with frozen-thawed sperm [36]. Depalo et al [22] concluded that the rates of motility, vitality, and fertilization of thawed semen were significantly lower in patients with testicular tumors and lymphomas than other tumors (35.4% and 50% vs. 71.4%), while there were no differences in the ovum cleavage rate and implantation rates.…”