Prevalence of abnormal semen analysis and levels of adherence with fertility preservation in men undergoing therapy for newly diagnosed cancer: A retrospective study in 2906 patients

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Title: Prevalence of abnormal semen analysis and levels of adherence with fertility preservation in men undergoing therapy for newly diagnosed cancer: A retrospective study in 2906 patients
Authors: Jayasena, CN
Luo, R
Dimakopoulou, A
Dearing, C
Clarke, H
Patel, N
Stroud, T
Seyani, L
Ramsay, J
Dhillo, WS
Item Type: Journal Article
Abstract: BACKGROUND: Sperm cryopreservation (freezing) should be offered to all men with cancer due to risk of infertility. However, many men with cancer already have impaired spermatogenesis prior to sperm cryopreservation. Furthermore, physical ill-health may hinder attendance of freeze visits. Investigating both the distribution of sperm functions and freeze attendance rates in men with newly diagnosed cancer, may identify patients benefiting from targeted reproductive fertility support. METHODS: We performed a retrospective study of 2906 male patients undergoing sperm cryopreservation prior to cancer therapy at a single UK tertiary centre between 1989 and 2013; all patients were asked to attend three hospital semen collection visits prior to cancer therapy. RESULTS: Fifteen per cent (433/2906) of men with newly diagnosed cancer had severely impaired semen quality (i.e., sperm total motile count, TMC < 1 million) during the first semen collection visit. However, patients with severely impaired semen quality had the poorest attendance of subsequent semen collection visits despite being requested to do so (non-attendance in TMC < 1 million: 43.4%; TMC < 1-30 million: 35.7%, P < 0.05 vs. <1 million; TMC > 30 million: 33.2%, P < 0.01 vs. <1 million). CONCLUSIONS: This study expands understanding of the semen quality of men with newly diagnosed cancer, and their ability to adhere to fertility preservation recommendations. Our data suggest that patients with the poorest semen quality paradoxically suffer the poorest attendance rates of sperm cryopreservation appointments prior to commencing cancer therapy. We suggest that additional support may be of clinical benefit to men with newly diagnosed cancer and TMC < 1 million sperm.
Issue Date: 1-Dec-2018
Date of Acceptance: 7-Sep-2018
URI: http://hdl.handle.net/10044/1/64530
DOI: https://dx.doi.org/10.1111/cen.13851
ISSN: 1365-2265
Publisher: Wiley
Start Page: 798
End Page: 804
Journal / Book Title: Clinical Endocrinology
Volume: 89
Issue: 6
Copyright Statement: © 2018 John Wiley & Sons Ltd. This is the pre-peer reviewed version of the following article, which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1111/cen.13851
Keywords: cancer
cryopreservation
infertility
sperm
cancer
cryopreservation
infertility
sperm
1103 Clinical Sciences
1114 Paediatrics And Reproductive Medicine
Endocrinology & Metabolism
Publication Status: Published
Conference Place: England
Embargo Date: 2019-09-11
Online Publication Date: 2018-09-11
Appears in Collections:Department of Medicine
Faculty of Medicine



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