1
|
Zhu H, Shi L, Wang R, Cui L, Wang J, Tang M, Qian H, Wei M, Wang L, Zhou H, Xu W. Global Research Trends on Infertility and Psychology From the Past Two Decades: A Bibliometric and Visualized Study. Front Endocrinol (Lausanne) 2022; 13:889845. [PMID: 35903282 PMCID: PMC9317298 DOI: 10.3389/fendo.2022.889845] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of this study was to evaluate the global scientific output of research on infertility and psychology; explore the current status and trends in this field through the cooperation of authors, countries, and institutions; shed light on the direction of clinical infertility research in the future, and provide inspiration for targeted diagnosis and treatment of infertility. Methods Research publications on infertility and psychology from the past two decades were retrieved from the Web of Science Core Collection (WoSCC). Bibliometric analyses were performed using VOSviewer software and the bibliometrix R package. Network maps were generated to evaluate the collaborations between different authors, countries, institutions, and keywords. Results A total of 151 articles related to the study of infertility and psychology were identified. We observed a gradual increase in the number of publications from 2001 to 2021, and the trend has been relatively stable in the past eight years. Human Reproduction (England), as the leading journal publishing the most papers (29 articles), was cited in the most journals (1208 times). Boivin J was the most prolific author (16 articles), with the largest number of citations (890 times) and the highest h-index (14) during the past decades. Boivin J was also the leader with the highest publication frequency and more active cooperation with other top authors. The United Kingdom (34 papers) and Cardiff University (25 articles) contributed the most publications and were the leading contributors in this field. Active cooperation between countries and between institutions was observed, and analyses of articles and references were also shown. The main hot topics included matters related to women (39 times), in-vitro salt (31 times), infertility (30 times), couples (25 times), and impact (24 times). Conclusion Our study results provide a comprehensive overview of the development of scientific literature, allowing relevant authors and research teams to recognize the current research status in this field. At the same time, infertility and psychology may soon become hotspots and should be closely monitored.
Collapse
Affiliation(s)
- Hongkun Zhu
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Lingli Shi
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Rong Wang
- Department of Laboratory Medicine, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Lijuan Cui
- Department of Pathology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Jiahui Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Mengyu Tang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Haiqing Qian
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Minggang Wei
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lihong Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Huifang Zhou
- Department of Gynaecology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenting Xu
- Nanjing University of Chinese Medicine, Nanjing, China
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| |
Collapse
|
2
|
Cherven B, Lewis RW, Pruett M, Meacham L, Klosky JL. Interest in fertility status assessment among young adult survivors of childhood cancer. Cancer Med 2022; 12:674-683. [PMID: 35651304 PMCID: PMC9844611 DOI: 10.1002/cam4.4887] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/19/2022] [Accepted: 05/11/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Cancer survivors who received gonadotoxic treatment are at-risk for future infertility and may desire a fertility status assessment (FSA), defined as semen analysis for males and consultation with a reproductive specialist for females. The purpose of this study was to describe the proportion of, and factors associated with, interest in FSA among young adult survivors of childhood cancer. METHODS This retrospective single-institution review included patients with prior gonadotoxic treatment, aged 18-25 years and >1 year from cancer treatment completion, who received a fertility-focused discussion during survivorship. Documentation of interest in and completion of FSA, worry about infertility, sociodemographic, and clinical characteristics were abstracted from medical records. Multivariable logistic regression was performed to calculate odds ratios (OR) and 95% confidence intervals (95%CI) for factors associated with interest in FSA. RESULTS Survivors (N = 259) were on average 19.2 ± 1.2 years at their fertility discussion; 55.6% were male and 57.9% non-Hispanic white. Interest in FSA was reported by 50.7% of males and 46.1% of females. Factors related to interest in FSA for males and females respectively, included worry about infertility (OR 2.40, 95%CI 1.11-5.27, p = 0.026 and OR 4.37, 95%CI 1.71-12.43, p = 0.003) and ≥2 fertility discussions (OR 3.78, 95%CI 1.70-8.75, p = 0.001 and 2.45, 95%CI 1.08-5.67, p = 0.033). Among males, fertility preservation consult/procedure at diagnosis (OR 3.02, 95%CI 1.09-9.04, p = 0.039) and high-risk for infertility (OR 2.47, 95%CI 1.07-5.87, p = 0.036) were also associated with interest in FSA. CONCLUSIONS Cancer survivors are interested in FSA, particularly those who have had repeated fertility-focused discussions during survivorship care and who report worry about infertility.
Collapse
Affiliation(s)
- Brooke Cherven
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of PediatricsEmory University School of MedicineAtlantaGeorgiaUSA
| | | | - Megan Pruett
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of AtlantaAtlantaGeorgiaUSA
| | - Lillian Meacham
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of PediatricsEmory University School of MedicineAtlantaGeorgiaUSA
| | - James L. Klosky
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of AtlantaAtlantaGeorgiaUSA,Department of PediatricsEmory University School of MedicineAtlantaGeorgiaUSA
| |
Collapse
|
3
|
Ko JKY, Lam KK, Cheng HH, Lui MW, Yung SS, Li RH, Lau EY, Ho PC, Yeung WS, Ng EH. Fertility Preservation Programme in a Tertiary-Assisted Reproduction Unit in Hong Kong. FERTILITY & REPRODUCTION 2021. [DOI: 10.1142/s2661318221500122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Fertility preservation is increasingly important with improving cancer survival rates and the delay in childbearing in modern societies. The objective of our study was to review the experience of the fertility preservation programme in a tertiary-assisted reproduction unit in Hong Kong. Methods: This is a retrospective study involving men and women who were seen at a tertiary-assisted reproduction unit for fertility preservation counselling before gonadotoxic treatment from January 2005 to December 2020. Their medical records in paper and electronic forms were reviewed. Results: There were 75 consultations for female fertility preservation from 2010 to 2020 involving 72 women. Twenty women underwent 22 cycles of ovarian stimulation for oocyte or embryo cryopreservation, two of whom subsequently transported their oocytes abroad for further management and another two achieved natural conception. Additional four women who did not have oocyte or embryo cryopreservation achieved natural conception after cancer treatment. Eleven (15.2%) women were followed up at a reproductive endocrinology clinic after their cancer treatment. From 2005 to 2020, 265 men had sperm cryopreserved. Twenty-six (9.8%) came back to use the cryopreserved sperms, the wives of 13 (50.0%) of whom achieved an on-going pregnancy. Six of them transferred out and 40 discarded the cryopreserved sperms. Conclusions: There was generally an increasing number of patient consultations for fertility preservation in our Centre over the past decade but a consistently low rate of utilisation of cryopreserved gametes for both women and men. Post-cancer treatment fertility evaluation and monitoring was a major area of deficiency in Hong Kong. More structured post-cancer treatment fertility follow-up is needed.
Collapse
Affiliation(s)
- Jennifer K. Y. Ko
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Kevin K.W. Lam
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Heidi H.Y. Cheng
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Man Wa Lui
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Sofie S.F. Yung
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Raymond H.W. Li
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Estella Y.L. Lau
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Pak Chung Ho
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - William S.B. Yeung
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Ernest H.Y. Ng
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| |
Collapse
|
4
|
Kristensen SG, Wakimoto Y, Colmorn LB, Dueholm M, Pors SE, Macklon KT, Mamsen LS, Nikiforov D, Cadenas J, Greve VH, Bay Bjørn AM, Rosendahl M, Pedersen AT, Nyboe Andersen A, Fedder J, Ernst E, Andersen CY. Use of cryopreserved ovarian tissue in the Danish fertility preservation cohort. Fertil Steril 2021; 116:1098-1106. [PMID: 34130800 DOI: 10.1016/j.fertnstert.2021.05.096] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the use of cryopreserved ovarian tissue in the Danish fertility preservation cohort. DESIGN Retrospective cohort study. SETTING University hospitals and fertility clinics. PATIENT(S) Ovarian tissue cryopreservation (OTC) was performed for 1,186 Danish girls and women from 1999-2020, of whom 117 subsequently underwent ovarian tissue transplantation (OTT). Subgroup 1 included 759 patients with a follow-up period of >5 years. Out of these, OTT rates were further analyzed for those patients who were alive and aged >24 years in July 2020 (subgroup 2; n = 554). INTERVENTION(S) OTC and OTT. MAIN OUTCOME MEASURE(S) OTT, death, donation of tissue. RESULT(S) In subgroup 1, 14% of the patients had undergone OTT, 18% had died, 9% had donated their tissue for research, and 59% still had their tissue stored. In subgroup 2, 19% had undergone OTT and for most diagnoses the OTT rates ranged from 15% to 22% with benign hematologic diseases having the highest OTT rate (35%). On the basis of the entire cohort, stratified age analysis indicated that women aged ≥30 years at OTC were more likely to return for OTT than women aged 18-29 years at OTC; mean storage times were 3.7 and 3.6 years, respectively. Only 4% of the girls aged <18 years at OTC had undergone OTT. CONCLUSION(S) The OTT rates depended on the diagnosis, age at OTC, and follow-up time. Specific criteria are needed for reporting and comparing OTT rates. Six out of 10 patients still had their cryopreserved tissue stored and longer follow-up is needed, especially for younger girls.
Collapse
Affiliation(s)
- Stine Gry Kristensen
- Laboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
| | - Yu Wakimoto
- Laboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark; Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Lotte Berdiin Colmorn
- The Fertility Clinic, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Margit Dueholm
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Susanne Elisabeth Pors
- Laboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Kirsten Tryde Macklon
- The Fertility Clinic, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Linn Salto Mamsen
- Laboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Dmitry Nikiforov
- Laboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Jesús Cadenas
- Laboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Vinnie Hornshøj Greve
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Anne-Mette Bay Bjørn
- Department of Gynecology and Obstetrics, Horsens Regional Hospital, Horsens, Denmark
| | - Mikkel Rosendahl
- Department of Gynecology and Obstetrics, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Anette Tønnes Pedersen
- Department of Gynecology and Obstetrics, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Anders Nyboe Andersen
- The Fertility Clinic, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Jens Fedder
- Centre of Andrology and Fertility Clinic, Odense University Hospital and Research Unit of Human Reproduction, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Erik Ernst
- Department of Gynecology and Obstetrics, Horsens Regional Hospital, Horsens, Denmark
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
5
|
Gonen LD. And When I Die: Theory of Planned Behavior as Applied to Sperm Cryopreservation. Healthcare (Basel) 2021; 9:554. [PMID: 34065091 PMCID: PMC8151572 DOI: 10.3390/healthcare9050554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/25/2021] [Accepted: 04/30/2021] [Indexed: 11/16/2022] Open
Abstract
The present study investigates fertility intentions of men, aged 18-59, as expressed in willingness to cryopreserve sperm for future use in procreation. An economic stated-preference framework is combined with the Theory of Planned Behavior (TPB) to investigate which attributes are important in the decision to cryopreserve sperm, what is the Willingness to Pay (WTP) for cryopreservation, and which attributes influence it. A structured, two-part questionnaire was used, based on WTP and Conjoint analysis (CA) applied in tandem to elicit respondents' preferences in evaluating utility. Findings show which attributes are important in the decision to cryopreserve sperm among them Risk of Infertility, Personal monthly income, Chance of pregnancy from frozen semen, Age and what are significant predictor variables for the WTP which are Personal monthly income, Importance of the risk of infertility, Initial registration fee to sperm bank and cryopreservation, and Degree of religious observance. The findings further demonstrate that respondents value sperm cryopreservation and have a positive WTP for it as it seems to contribute to improving well-being. As a result of these findings, governments should consider state funding for cryopreservation as part of national health policy.
Collapse
Affiliation(s)
- Limor Dina Gonen
- Department of Economics and Business Administration, Ariel University, Ariel 40700, Israel
| |
Collapse
|
6
|
Kruseová J, Černíková J, Zámečníková M, Hřivnová L, Koloušková S, Čepelová M, Kabíčková E, Čapek V, Lukš A, Eckschlager T. Semen analysis and treatment risk factors in long-term survivors of childhood cancer. Andrologia 2020; 53:e13853. [PMID: 33070396 DOI: 10.1111/and.13853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/07/2020] [Accepted: 08/29/2020] [Indexed: 11/26/2022] Open
Abstract
The objective of this study was to compare semen quality (sperm density, progressive motility and spermia) between long-term childhood cancer survivors and a control group of males. The second objective was to correlate the semen analysis of the survivors with cancer treatment and endocrine status. The semen quality of 143 survivors (median age, 23.6 years) was compared to 200 men (median age, 27.9 years) who had not been diagnosed with cancer. The cancer-related risk factors and gonadotrophin levels were compared. Overall, 65% of the survivors had abnormal semen analysis compared to 26.5% of the controls (p < 0.0001). Survivors with nonaspermia had lower sperm density than the controls (p < 0.001). Other observed correlations were not significant. Survivors who were treated with alkylating agents were more likely to have abnormal semen analysis (p < 0.008). Follicle-stimulating hormone and luteinising hormone levels were significantly elevated (p < 0.0001) in survivors with abnormal semen analysis. The semen quality parameters, except for low sperm density, did not differ in survivors with nonaspermia compared to the controls. The risk factors included treatment with alkylating agents. Elevated gonadotrophin levels correlated with abnormal semen analysis. All cancer survivors should be made aware of the possibility of suffering from cancer treatment-related infertility.
Collapse
Affiliation(s)
- Jarmila Kruseová
- Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jelena Černíková
- Centre for Reproductive Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Marina Zámečníková
- Centre for Reproductive Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Lucie Hřivnová
- Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Stanislava Koloušková
- Department of Paediatrics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Michaela Čepelová
- Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Edita Kabíčková
- Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Václav Čapek
- Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Aleš Lukš
- Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Tomáš Eckschlager
- Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| |
Collapse
|
7
|
Adam C, Deffert C, Leyvraz C, Primi MP, Simon JP, Beck Popovic M, Bénard J, Bouthors T, Girardin C, Streuli I, Vulliemoz N, Gumy-Pause F. Use and Effectiveness of Sperm Cryopreservation for Adolescents and Young Adults: A 37-Year Bicentric Experience. J Adolesc Young Adult Oncol 2020; 10:78-84. [PMID: 32915697 DOI: 10.1089/jayao.2020.0121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Aim: Sperm cryopreservation (SCP) should be offered to every adolescent before gonadotoxic treatment, but experience in this age range is still relatively limited. The goal of this study is to assess how to optimize this procedure. Methods and Patients: One hundred thirty-three patients between 12 and 20 years old, who underwent SCP between 1980 and 2017, were included. Baseline data (age, indication for SCP, and semen parameters at freezing) and follow-up data (outcome of sperm straws and follow-up of sperm quality) were collected and analyzed. Results: SCP is feasible from the age of 12. Semen assessment parameters at this age were close to parameters of adults. However, we observed quantitative impairments in testicular tumors and qualitative impairments in leukemia and bone marrow failure. Four patients (3%) used their cryopreserved semen for medically assisted reproduction, 15 patients died (11.3%), 18 asked for destruction of their straws (13.5%), and nine samples were destroyed because of lack of news (6.8%). Very few patients underwent a sperm analysis after treatment. Conclusions: SCP is an efficient, still underused, procedure for adolescents and young adults. Cryopreserved sperm is rarely used and rarely destroyed, but studies with a longer follow-up are needed to better assess these observations. Follow-up with a specialist of reproductive medicine is valuable for better information of the patient.
Collapse
Affiliation(s)
- Cécile Adam
- Division of Pediatrics, Oncology and Hematology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Christine Deffert
- Division of Laboratory Medicine, Diagnostics Department, Geneva University Hospitals, Geneva, Switzerland
| | - Céline Leyvraz
- Andrology and Reproductive Biology Laboratory, Division of Gynecology, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Marie-Pierre Primi
- Andrology and Reproductive Biology Laboratory, Division of Gynecology, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Jean-Pascale Simon
- General Management of the University Hospital, Legal Affairs, Lausanne University Hospital, Lausanne, Switzerland
| | - Maja Beck Popovic
- Division of Pediatrics, Oncology and Hematology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Julie Bénard
- Unit for Reproductive Medicine and Gynecological Endocrinology, Department of Woman, Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Thérèse Bouthors
- Division of Pediatrics, Pediatric Endocrinology and Diabetology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Céline Girardin
- Pediatric Endocrine and Diabetes Unit, Department of Woman, Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Isabelle Streuli
- Unit for Reproductive Medicine and Gynecological Endocrinology, Department of Woman, Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Nicolas Vulliemoz
- Fertility Medicine and Gynecological Endocrinology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Fabienne Gumy-Pause
- Pediatric Onco-Hematology Unit, Department of Woman, Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
8
|
Ferrari S, Paffoni A, Reschini M, Noli S, Dallagiovanna C, Guarneri C, Filippi F, Somigliana E. Variables affecting long-term usage rate of sperm samples cryopreserved for fertility preservation in cancer patients. Andrology 2020; 9:204-211. [PMID: 32814364 DOI: 10.1111/andr.12894] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous evidence highlighted that only a minority of men who banked their semen before cancer therapies subsequently used their frozen samples. This may question the economical validity of sperm cryopreservation programmes. However, in most contributions, the duration of follow-up was insufficient to draw robust information on the real rate of use. OBJECTIVES To shed more light on the potential benefits of cryopreservation programmes. MATERIALS AND METHODS Men who cryopreserved their semen in a public hospital for a diagnosis of cancer between 1986 and 2009 were retrospectively reviewed. The rate of use as well as the possible determinants was investigated. RESULTS The median time of follow-up was 12 [IQR: 7-16] years. One hundred forty-four patients out of 1,524 (9.4%, 95%CI: 8.1%-11.0%) used their frozen samples of whom 64% were azoospermic. The rate of men achieving parenthood with frozen semen was 46%. Predictive factors of use were older age at the time of storage, lower sperm count at the time of storage and a diagnosis of testicular cancer. The impact of this latter factor was also supported by the lower frequency of azoospermia after cancer treatment in these patients. DISCUSSION Cost-beneficial studies are warranted to assess and possibly improve the economical validity of sperm banking. CONCLUSION The usage rate of frozen sperm in cancer patient is low, even extending the duration of follow-up.
Collapse
Affiliation(s)
- Stefania Ferrari
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Marco Reschini
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Noli
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Community and Clinical Sciences, University of Milan, Milan, Italy
| | - Chiara Dallagiovanna
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Community and Clinical Sciences, University of Milan, Milan, Italy
| | - Cristina Guarneri
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Filippi
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Edgardo Somigliana
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Community and Clinical Sciences, University of Milan, Milan, Italy
| |
Collapse
|
9
|
Li Y, Zhang J, Zhang H, Liu B, Wang G, Cao M, Fu B, Li H, Jiang Q, Yu L, Xian Y, Su B, Jiang X. Importance and safety of autologous sperm cryopreservation for fertility preservation in young male patients with cancer. Medicine (Baltimore) 2020; 99:e19589. [PMID: 32282708 PMCID: PMC7440101 DOI: 10.1097/md.0000000000019589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
With development of tumor treatment, survival time of patients with cancer is significantly prolonged. Therefore, the current emphasis is not only the survival, but also the quality of life, especially, it is crucial for young male cancer patients who are unmarried and maintaining fertility. However, the awareness of fertility preservation for these patients is currently insufficient.To give physician and cancer patients more clear understanding of the importance and safety of sperm cryopreservation, so that achieve patient fertility benefits.First, the knowledge level and attitudes about fertility preservation were investigated by surveying 332 cancer patients and 103 medical staff with questionnaires. Second, 30 male cancer patients (experimental group) and 30 normal donors (control group) were selected and their sperm samples were cryopreserved. The sperm quality was compared between cancer patients and normal donors, before and after antitumor treatment in the cancer patients, and before and after sperm cryopreservation in both groups.In the questionnaire survey, we found that there were 70% to 80% of medical staffs and cancer patients lacked knowledge of fertility preservation, and 27.7% of patients worried that tumor and sperm cryopreservation might affect their offspring. In the sperm preservative experiment, we found that sperm quality in cancer patients was further damaged after radiotherapy/chemotherapy in addition to tumor itself had a negative effect. However, sperm deoxyribonucleic acid fragments were not affected by sperm cryopreservation although there were significant differences in sperm quality before and after sperm preservation in both groups.Radiotherapy/chemotherapy would further damage sperm quality of young male cancer patients. Medical staff should be aware of importance of sperm cryopreservation for fertility preservation for these patients. It is also necessary that medical staff should inform the patient about the safety of sperm freezing and guide the patient to participate in sperm cryopreservation.
Collapse
Affiliation(s)
- Yinfeng Li
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China
| | - Jian Zhang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China
| | - Hanfeng Zhang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China
| | - Bo Liu
- Department of Human Sperm Bank, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Guorong Wang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China
| | - Maoqiu Cao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China
| | - Bencui Fu
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China
| | - Hui Li
- Department of Human Sperm Bank, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Qinghua Jiang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China
| | - Lin Yu
- Department of Human Sperm Bank, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yang Xian
- Department of Human Sperm Bank, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Bizhen Su
- Department of Human Sperm Bank, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xiaohui Jiang
- Department of Human Sperm Bank, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| |
Collapse
|
10
|
Halpern JA, Das A, Faw CA, Brannigan RE. Oncofertility in adult and pediatric populations: options and barriers. Transl Androl Urol 2020; 9:S227-S238. [PMID: 32257863 PMCID: PMC7108982 DOI: 10.21037/tau.2019.09.27] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Cancer and its treatments can affect fertility in a variety of ways, and recent advances in cancer detection and treatment have led to an increasing number of cancer survivors for whom future fertility is a primary concern. Oncofertility is the study of interactions between cancer, anti-cancer therapy, fertility, and reproductive health. Fertility preservation aims to optimize fertility potential before initiation of gonadotoxic therapies. Sperm cryopreservation from an ejaculated sample is the gold standard for adults and post-pubertal adolescents, though added maneuvers such as medical therapy, penile vibratory stimulation, and electroejaculation can be employed when appropriate. When all these approaches fail, testicular sperm extraction can be used to obtain and cryopreserve testicular sperm from the azoospermic patient. Fertility preservation in the pre-pubertal pediatric patient is still experimental, but recent scientific breakthroughs with use of spermatogonial stem cells and testicular tissue transplantation offer great promise for the future. While there may be several practical, cultural, religious, and other barriers to fertility preservation, the establishment of a dedicated fertility preservation team can help to overcome these obstacles and optimize the utilization of fertility preservation in cancer patients of all ages.
Collapse
Affiliation(s)
- Joshua A Halpern
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Arighno Das
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Cory A Faw
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Robert E Brannigan
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
11
|
Ito K, Ichioka K, Dahal S, Matsui Y, Nakayama T, Hatayama H, Ogawa O, Negoro H. Barriers for sperm cryopreservation in advanced germ cell tumor patients: a 20-year experience. Int J Clin Oncol 2020; 25:906-911. [PMID: 31894434 DOI: 10.1007/s10147-019-01607-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/16/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to investigate barriers to sperm cryopreservation for patients with advanced germ cell tumors. METHODS We reviewed data collected from patients who underwent chemotherapy for advanced germ cell tumors in our institutions from 1996 to 2016. We divided sperm cryopreservation procedures into three steps: offering information about sperm cryopreservation, patients' decision making and sperm collection, and investigating the barriers in each step. RESULTS Of the 91 patients, 43 (47%) successfully completed sperm cryopreservation. Thirty (33%) patients were not offered information about sperm cryopreservation from the doctors. Nine patients (9.9%) were offered but declined preservation. Nine patients (9.9%) were not able to provide sperm because of azoospermia (5) and anejaculation (4). Among 43 patients who successfully provided sperm, 10 (23%) had their cryopreserved sperm used for 21 cycles of in vitro fertilization. Ten pregnancies and 7 fatherhoods were achieved. Thirteen patients (30%) had their cryopreserved sperm discarded without use, whereas 20 (47%) continued preserving their sperm for a median 12.5 years. CONCLUSIONS Not only offering proper information about sperm cryopreservation, but also shared decision making prior to chemotherapy, and considering fertility preservation before orchiectomy are imperative. The rate of use of preserved sperm was relatively high, but decision making for sperm disposal should also be supported.
Collapse
Affiliation(s)
- Katsuhiro Ito
- Department of Urology, Kyoto University Hospital, 54 Shogoin Kawaharacho, Sakyo-ku, Kyoto, 6068507, Japan
- Ichioka Urological Clinic, Symphonia-Oike 1F, Higashinotoin-Nijo sagaru, Nakagyo-ku, Kyoto, 6040837, Japan
| | - Kentaro Ichioka
- Ichioka Urological Clinic, Symphonia-Oike 1F, Higashinotoin-Nijo sagaru, Nakagyo-ku, Kyoto, 6040837, Japan
| | - Sachiko Dahal
- Center For Reproductive Endocrinology and Infertility, Adachi Hospital, Higashinotoin-Nijosagaru, Nakagyo-ku, Kyoto, 6040837, Japan
| | - Yoshiyuki Matsui
- Department of Urology, Kyoto University Hospital, 54 Shogoin Kawaharacho, Sakyo-ku, Kyoto, 6068507, Japan
- Ichioka Urological Clinic, Symphonia-Oike 1F, Higashinotoin-Nijo sagaru, Nakagyo-ku, Kyoto, 6040837, Japan
| | - Takahiro Nakayama
- Center For Reproductive Endocrinology and Infertility, Adachi Hospital, Higashinotoin-Nijosagaru, Nakagyo-ku, Kyoto, 6040837, Japan
| | - Hiroshi Hatayama
- Center For Reproductive Endocrinology and Infertility, Adachi Hospital, Higashinotoin-Nijosagaru, Nakagyo-ku, Kyoto, 6040837, Japan
| | - Osamu Ogawa
- Department of Urology, Kyoto University Hospital, 54 Shogoin Kawaharacho, Sakyo-ku, Kyoto, 6068507, Japan
| | - Hiromitsu Negoro
- Department of Urology, Kyoto University Hospital, 54 Shogoin Kawaharacho, Sakyo-ku, Kyoto, 6068507, Japan.
- Ichioka Urological Clinic, Symphonia-Oike 1F, Higashinotoin-Nijo sagaru, Nakagyo-ku, Kyoto, 6040837, Japan.
| |
Collapse
|
12
|
Anazodo A, Laws P, Logan S, Saunders C, Travaglia J, Gerstl B, Bradford N, Cohn R, Birdsall M, Barr R, Suzuki N, Takae S, Marinho R, Xiao S, Qiong-Hua C, Mahajan N, Patil M, Gunasheela D, Smith K, Sender L, Melo C, Almeida-Santos T, Salama M, Appiah L, Su I, Lane S, Woodruff TK, Pacey A, Anderson RA, Shenfield F, Ledger W, Sullivan E. How can we improve oncofertility care for patients? A systematic scoping review of current international practice and models of care. Hum Reprod Update 2019; 25:159-179. [PMID: 30462263 PMCID: PMC6390168 DOI: 10.1093/humupd/dmy038] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/15/2018] [Accepted: 10/24/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Fertility preservation (FP) is an important quality of life issue for cancer survivors of reproductive age. Despite the existence of broad international guidelines, the delivery of oncofertility care, particularly amongst paediatric, adolescent and young adult patients, remains a challenge for healthcare professionals (HCPs). The quality of oncofertility care is variable and the uptake and utilization of FP remains low. Available guidelines fall short in providing adequate detail on how oncofertility models of care (MOC) allow for the real-world application of guidelines by HCPs. OBJECTIVE AND RATIONALE The aim of this study was to systematically review the literature on the components of oncofertility care as defined by patient and clinician representatives, and identify the barriers, facilitators and challenges, so as to improve the implementation of oncofertility services. SEARCH METHODS A systematic scoping review was conducted on oncofertility MOC literature published in English between 2007 and 2016, relating to 10 domains of care identified through consumer research: communication, oncofertility decision aids, age-appropriate care, referral pathways, documentation, training, supportive care during treatment, reproductive care after cancer treatment, psychosocial support and ethical practice of oncofertility care. A wide range of electronic databases (CINAHL, Embase, PsycINFO, PubMed, AEIPT, Education Research Complete, ProQuest and VOCED) were searched in order to synthesize the evidence around delivery of oncofertility care. Related citations and reference lists were searched. The review was undertaken following registration (International prospective register of systematic reviews (PROSPERO) registration number CRD42017055837) and guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). OUTCOMES A total of 846 potentially relevant studies were identified after the removal of duplicates. All titles and abstracts were screened by a single reviewer and the final 147 papers were screened by two reviewers. Ten papers on established MOC were identified amongst the included papers. Data were extracted from each paper and quality scores were then summarized in the oncofertility MOC summary matrix. The results identified a number of themes for improving MOC in each domain, which included: the importance of patients receiving communication that is of a higher quality and in different formats on their fertility risk and FP options; improving provision of oncofertility care in a timely manner; improving access to age-appropriate care; defining the role and scope of practice of all HCPs; and improving communication between different HCPs. Different forms of decision aids were found useful for assisting patients to understand FP options and weigh up choices. WIDER IMPLICATIONS This analysis identifies core components for delivery of oncofertility MOC. The provision of oncofertility services requires planning to ensure services have safe and reliable referral pathways and that they are age-appropriate and include medical and psychological oncofertility care into the survivorship period. In order for this to happen, collaboration needs to occur between clinicians, allied HCPs and executives within paediatric and adult hospitals, as well as fertility clinics across both public and private services. Training of both cancer and non-cancer HCPs is needed to improve the knowledge of HCPs, the quality of care provided and the confidence of HCPs with these consultations.
Collapse
Affiliation(s)
- Antoinette Anazodo
- Kids Cancer Centre, Sydney Children’s Hospital, High Street Randwick, Randwick, Sydney, NSW, Australia
- Nelune Cancer Centre, Prince of Wales Hospital, Barker Street, Randwick, Sydney, NSW, Australia
- School of Women’s and Children’s Health, University of New South Wales, Botany Street, Sydney, NSW, Australia
| | - Paula Laws
- Kids Cancer Centre, Sydney Children’s Hospital, High Street Randwick, Randwick, Sydney, NSW, Australia
| | - Shanna Logan
- School of Women’s and Children’s Health, University of New South Wales, Botany Street, Sydney, NSW, Australia
- Fertility and Research Centre, Royal Hospital for Women, Barker Street, Randwick, Sydney, NSW, Australia
| | - Carla Saunders
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW, Australia
| | - Jo Travaglia
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW, Australia
| | - Brigitte Gerstl
- Kids Cancer Centre, Sydney Children’s Hospital, High Street Randwick, Randwick, Sydney, NSW, Australia
- Nelune Cancer Centre, Prince of Wales Hospital, Barker Street, Randwick, Sydney, NSW, Australia
| | - Natalie Bradford
- Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Brisbane, Queensland, Australia
| | - Richard Cohn
- Kids Cancer Centre, Sydney Children’s Hospital, High Street Randwick, Randwick, Sydney, NSW, Australia
- School of Women’s and Children’s Health, University of New South Wales, Botany Street, Sydney, NSW, Australia
| | - Mary Birdsall
- Fertility Associates, 7 Ellerslie Racecourse Drive, Auckland City, New Zealand
| | - Ronald Barr
- Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada
| | - Nao Suzuki
- St. Marianna University School of Medicine, 2-16-1 Sugao, Kawasaki Kanagawa Prefecture, Japan
| | - Seido Takae
- St. Marianna University School of Medicine, 2-16-1 Sugao, Kawasaki Kanagawa Prefecture, Japan
| | - Ricardo Marinho
- Pro Criar Medicina Reprodutiva, Rua Bernardo Guimarães 2063, Belo Horizonte, Brazil
| | - Shuo Xiao
- Reproductive Health and Toxicology Lab, Dept. Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene St, Rm 327, Columbia, SC, USA
| | - Chen Qiong-Hua
- Obstetrics and Gynecology Department, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Siming Qu, Xiamen Shi 35, China
| | - Nalini Mahajan
- Mother and Child Hospital, D-59 Defence Colony, New Delhi, India
| | - Madhuri Patil
- Dr. Patil’s Fertility and Endoscopy Center, Center for Assisted Reproductive Technology, Endoscopic Surgery and Andrology, Bangalore, India
| | - Devika Gunasheela
- Gunasheela Surgical & Maternity Hospital, No. 1, Dewan Madhava Road, Opp. M. N. Krishna Rao Park, Basavanagudi, Bengaluru, Karnataka, India
| | - Kristen Smith
- Department of Obstetrics and Gynecology, Feinberg School of Medicine Northwestern University, 420 E Superior Street, Chicago, IL, USA
| | - Leonard Sender
- Children’s Hospital Orange County, 1201 W La Veta Avenue, Orange, CA, USA
| | - Cláudia Melo
- Centro de Preservação da Fertilidade, Serviço de Medicina da Reprodução, Centro Hospitalar e Universitário de Coimbra, Edifício de São Jerónimo, Piso 2, Praceta Professor Mota Pinto, Coimbra, Portugal
| | - Teresa Almeida-Santos
- Centro de Preservação da Fertilidade, Serviço de Medicina da Reprodução, Centro Hospitalar e Universitário de Coimbra, Edifício de São Jerónimo, Piso 2, Praceta Professor Mota Pinto, Coimbra, Portugal
| | - Mahmoud Salama
- Department of Obstetrics and Gynecology, Feinberg School of Medicine Northwestern University, 420 E Superior Street, Chicago, IL, USA
- Reproductive Medicine Department, National Research Center, Buhouth Street 33, Cairo, Egypt
| | - Leslie Appiah
- The Ohio State University College of Medicine, Department of Obstetrics and Gynecology, Columbus, OH, USA
- The Ohio State University Comprehensive Cancer Center–James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
- Nationwide Children’s Hospital, Department of Paediatric Surgery, 700 Children’s Drive, Columbus, OH, USA
| | - Irene Su
- University of California San Diego, 355 Dickinson St # 315, San Diego, CA, USA
| | - Sheila Lane
- Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford, UK
- University of Oxford, Wellington Square, Oxford, UK
| | - Teresa K Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine Northwestern University, 420 E Superior Street, Chicago, IL, USA
| | - Allan Pacey
- Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism, University of Sheffield, Level 4, The Jessop Wing, Tree Root Walk, Sheffield, South Yorkshire, UK
| | - Richard A Anderson
- MRC Centre for Reproductive Health, The Queen’s Medical Research Institute, Edinburgh University, 47 Little France Crescent, Scotland, UK
| | - Francoise Shenfield
- Reproductive Medicine Unit, Elizabeth Garrett Anderson Wing, University College London Hospital, 25 Grafton Way, London, UK
| | - William Ledger
- School of Women’s and Children’s Health, University of New South Wales, Botany Street, Sydney, NSW, Australia
- Fertility and Research Centre, Royal Hospital for Women, Barker Street, Randwick, Sydney, NSW, Australia
| | - Elizabeth Sullivan
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, 15 Broadway, Ultimo, Sydney, NSW, Australia
| |
Collapse
|
13
|
Goldberg H, Klaassen Z, Chandrasekar T, Fleshner N, Hamilton RJ, Jewett MAS. Germ Cell Testicular Tumors-Contemporary Diagnosis, Staging and Management of Localized and Advanced disease. Urology 2018; 125:8-19. [PMID: 30597167 DOI: 10.1016/j.urology.2018.12.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/27/2018] [Accepted: 12/18/2018] [Indexed: 01/15/2023]
Abstract
Germ cell testicular tumors are the most commonly diagnosed cancer in young men, with cure rates exceeding 95%. Clinical stage 1 disease is the most common manifestation, with radical orchiectomy curing the majority of Clinical stage 1 patients, making active surveillance the treatment of choice, with a cancer specific survival nearing 100% and low relapse rates. However, in metastatic disease, chemotherapy, radiotherapy, and surgery are curative options. Chemotherapy remains the mainstay of therapy for advanced disease with surgical management of residual disease. Patients with advanced disease should be treated in high volume experienced academic centers with multidisciplinary teams. Research exploring refinement of diagnosis and treatment, and lowering treatment burden is underway.
Collapse
Affiliation(s)
- Hanan Goldberg
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Canada.
| | - Zachary Klaassen
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Canada
| | - Thenappan Chandrasekar
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Canada
| | - Neil Fleshner
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Canada
| | - Robert J Hamilton
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Canada
| | - Michael A S Jewett
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Canada
| |
Collapse
|
14
|
Hamano I, Hatakeyama S, Ohyama C. Fertility preservation of patients with testicular cancer. Reprod Med Biol 2017; 16:240-251. [PMID: 29259474 PMCID: PMC5715882 DOI: 10.1002/rmb2.12037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 04/10/2017] [Indexed: 11/23/2022] Open
Abstract
Background Testicular cancer (TC) is one of the most common malignancies in young men of reproductive age. Although TC is a curable malignancy with a high survival rate, its treatment requires various cytotoxic modalities and negatively impacts spermatogenesis; therefore, the fertility preservation of patients with TC has been studied. Methods In order to give an overview of fertility preservation in patients with TC, the literature was reviewed. Original and review articles were identified and examined on the basis of PubMed database searches. Results Chemotherapy and radiotherapy damage spermatogenesis and retroperitoneal lymph node dissection negatively impacts ejaculatory function. Testicular sperm extraction facilitates successful sperm retrieval in patients with TC with postchemotherapy azoospermia. Although preserved sperm is used with a very low frequency (8%), the conception rates in those who have used sperm are not inferior. Conclusion The number of studies is limited, and because numerous treatment factors affect fertility, outstanding questions remain about preserving the fertility of patients with TC. Further studies are necessary in order to determine the best means of preventing and treating infertility in patients with TC.
Collapse
Affiliation(s)
- Itsuto Hamano
- Department of Urology Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Shingo Hatakeyama
- Department of Urology Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Chikara Ohyama
- Department of Urology Hirosaki University Graduate School of Medicine Hirosaki Japan.,Department of Advanced Transplant and Regenerative Medicine Hirosaki University Graduate School of Medicine Hirosaki Japan
| |
Collapse
|
15
|
Hammarberg K, Kirkman M, Stern C, McLachlan RI, Gook D, Rombauts L, Vollenhoven B, Fisher JRW. Cryopreservation of reproductive material before cancer treatment: a qualitative study of health care professionals' views about ways to enhance clinical care. BMC Health Serv Res 2017; 17:343. [PMID: 28490359 PMCID: PMC5424377 DOI: 10.1186/s12913-017-2292-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 05/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer treatment can diminish fertility in women and men. The need for fertility preservation is growing as increasing numbers of people survive cancer. Cryostorage of reproductive material to preserve potential for conception for cancer survivors has moved from being experimental to being a part of clinical management of women and men who are diagnosed with cancer in their reproductive years. There is little existing evidence about how fertility preservation services can be enhanced to meet the complex needs of patients who are diagnosed with cancer in their reproductive years. The aim of this research was to inform clinical practice development by drawing on the collective experience and knowledge of staff at well-established clinics that offer fertility preservation before cancer treatment. METHODS A qualitative research model was adopted using semi-structured interviews with professionals involved in the care of people who freeze reproductive material before cancer treatment. In the state of Victoria, Australia, two large assisted reproductive technology (ART) centres have been providing fertility preservation services for more than two decades. An invitation to participate in a semi-structured interview about clinical care in the context of fertility preservation was emailed to past and current staff members. To capture diverse perspectives, informants were sought from all relevant professions: fertility specialists, andrologists, nurses, embryologists/scientists, counsellors, and administrative staff. Transcripts were analysed thematically. RESULTS Thirteen key informants were interviewed from August 2013 to February 2014. The identified themes relating to enhancing clinical care in a fertility preservation service were communication between oncology and ART specialists; managing urgency; managing patients' expectations; establishing and implementing protocols, systems, and data bases; and maintaining contact with patients. CONCLUSION The collective knowledge of this study's informants, who represent multidisciplinary teams with more than two decades' experience in fertility preservation, yields important insights into strategies that fertility preservation services can employ to promote the integration of oncology and fertility care, the psychosocial care of patients, data recording and monitoring, and reporting of outcomes.
Collapse
Affiliation(s)
- Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 549 St Kilda Rd, Melbourne, Victoria 3004 Australia
| | - Maggie Kirkman
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 549 St Kilda Rd, Melbourne, Victoria 3004 Australia
| | - Catharyn Stern
- Melbourne IVF, Melbourne, Victoria 3002 Australia
- Reproductive Services, Royal Women’s Hospital, Parkville, Victoria 3052 Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria 3010 Australia
| | - Robert I. McLachlan
- Monash IVF, Clayton, Victoria 3163 Australia
- Andrology Australia, Melbourne, Victoria 3163 Australia
- Hudson Institute of Medical Research, Clayton, Victoria 3163 Australia
| | - Debra Gook
- Melbourne IVF, Melbourne, Victoria 3002 Australia
- Reproductive Services, Royal Women’s Hospital, Parkville, Victoria 3052 Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria 3010 Australia
| | - Luk Rombauts
- Monash IVF, Clayton, Victoria 3163 Australia
- Hudson Institute of Medical Research, Clayton, Victoria 3163 Australia
- Monash Health, Clayton, Victoria 3163 Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria 3163 Australia
| | - Beverley Vollenhoven
- Monash IVF, Clayton, Victoria 3163 Australia
- Monash Health, Clayton, Victoria 3163 Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria 3163 Australia
| | - Jane R. W. Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 549 St Kilda Rd, Melbourne, Victoria 3004 Australia
| |
Collapse
|
16
|
Jadoul P, Guilmain A, Squifflet J, Luyckx M, Votino R, Wyns C, Dolmans M. Efficacy of ovarian tissue cryopreservation for fertility preservation: lessons learned from 545 cases. Hum Reprod 2017; 32:1046-1054. [DOI: 10.1093/humrep/dex040] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 02/14/2017] [Indexed: 01/12/2023] Open
|
17
|
Ferrari S, Paffoni A, Filippi F, Busnelli A, Vegetti W, Somigliana E. Sperm cryopreservation and reproductive outcome in male cancer patients: a systematic review. Reprod Biomed Online 2016; 33:29-38. [DOI: 10.1016/j.rbmo.2016.04.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 04/01/2016] [Accepted: 04/04/2016] [Indexed: 10/24/2022]
|
18
|
Paoli D, Rizzo F, Fiore G, Pallotti F, Pulsoni A, Annechini G, Lombardo F, Lenzi A, Gandini L. Spermatogenesis in Hodgkin's lymphoma patients: a retrospective study of semen quality before and after different chemotherapy regimens. Hum Reprod 2015; 31:263-72. [PMID: 26705149 DOI: 10.1093/humrep/dev310] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 11/20/2015] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is spermatogenesis impairment caused by Hodgkin's lymphoma (HL) itself or by the various treatments? SUMMARY ANSWER HL is not itself the main cause of impaired spermatogenesis, which is instead affected by the treatment; the extent of impairment depends on the type of treatment and the number of cycles. WHAT IS KNOWN ALREADY Data in the literature are contradictory, although most studies found poor semen quality in HL patients prior to treatment. The impact of therapy on spermatogenesis depends on the type of treatment, but the time needed to recover testicular function following treatment with chemotherapeutic agents inducing azoospermia is unknown. STUDY DESIGN, SIZE, DURATION In a retrospective study, the semen parameters of 519 patients (504 with sperm and 15 who were azoospermic) were investigated.HL patients were analysed before therapy. A longitudinal study was also conducted of semen quality in 202 patients pre- and post-ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) at T0 (baseline) and 6 (T6), 12 (T12) and 24 (T24) months after the end of treatment, and of 42 patients pre- and post-BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone), COPP/ABVD (cyclophosphamide, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, vinblastine and dacarbazine), OPP/ABVD (vincristine, procarbazine, prednisone, doxorubicin, bleomycin, vinblastine and dacarbazine) or MOPP (mechlorethamine, vincristine, procarbazine and prednisone) and inguinal radiotherapy at different observation times (from T0 to 16 years after treatment). PARTICIPANTS/MATERIALS, SETTING, METHODS Semen parameters were examined according to World Health Organization 2010 criteria, evaluating sperm concentration, total sperm number, progressive motility and morphology. MAIN RESULTS AND THE ROLE OF CHANCE Our data, which pertain to the largest caseload reported to date, indicate that 75% of HL patients are normozoospermic prior to treatment. The results from the HL patients studied pre- and post-therapy demonstrate that spermatogenesis recovery depends on the therapeutic regimen used. After ABVD, there was a statistically significant decrease in sperm concentration and total sperm number at T6 and T12 (P < 0.001; P < 0.01, respectively). There was a significant drop in progressive motility (P < 0.001) and a significant increase in abnormal forms (P < 0.01) at T6. The differences in sperm concentration, total sperm number and abnormal forms at T0 and T24 were not statistically significant, indicating that sperm quality had returned to pre-therapy values. The most interesting data in terms of patient management arise from the study of azoospermia induced by other chemotherapeutic agents. A high number of BEACOPP, COPP/ABVD, OPP/ABVD or MOPP cycles (≥6) induced a permanent absence of sperm in the seminal fluid, while even following a low number of cycles (<6), spermatogenesis only recovered after 3-5 years and semen quality was highly impaired. LIMITATIONS, REASONS FOR CAUTION The study type (retrospective) and the low caseload and varying time of the follow-up do not permit any firm conclusions to be drawn about the recovery of spermatogenesis after BEACOPP or other combined therapies, or the identification of any risk factors for testicular function in treated patients. WIDER IMPLICATIONS OF THE FINDINGS The pretreatment semen parameters of HL patients in this study were better than some results reported in the literature, with a higher percentage of normozoospermic patients. Strengths of this study were the large caseload of HL patients and a high degree of consistency in semen analysis, as all parameters were assessed in the same laboratory. Following the azoospermia induced by different chemotherapeutic protocols, spermatogenesis may take several years to recover. Awareness of this issue will enable oncologists to better inform patients about the possibility of recovering fertility post-treatment and also demonstrates the importance of semen cryobanking before beginning any cancer treatment. STUDY FUNDING/COMPETING INTERESTS Supported by a grant from the Italian Ministry of Education and Research (MIUR-PRIN) and the University of Rome 'La Sapienza' Faculty of Medicine. The authors have no conflicts of interest.
Collapse
Affiliation(s)
- D Paoli
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome 'La Sapienza', Italy
| | - F Rizzo
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome 'La Sapienza', Italy
| | - G Fiore
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome 'La Sapienza', Italy
| | - F Pallotti
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome 'La Sapienza', Italy
| | - A Pulsoni
- Department of Cellular Biotechnologies and Haematology, University of Rome 'La Sapienza', Italy
| | - G Annechini
- Department of Cellular Biotechnologies and Haematology, University of Rome 'La Sapienza', Italy
| | - F Lombardo
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome 'La Sapienza', Italy
| | - A Lenzi
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome 'La Sapienza', Italy
| | - L Gandini
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome 'La Sapienza', Italy
| |
Collapse
|
19
|
Dolmans MM, Hollanders de Ouderaen S, Demylle D, Pirard C. Utilization rates and results of long-term embryo cryopreservation before gonadotoxic treatment. J Assist Reprod Genet 2015; 32:1233-7. [PMID: 26174124 DOI: 10.1007/s10815-015-0533-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/01/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate long-term embryo cryopreservation, utilization, and success rate in patients subjected to gonadotoxic treatments in the context of cancer. METHODS This is a retrospective study on patients (n = 54) undergoing ovarian stimulation and IVF for fertility preservation between January 1997 and June 2014. Embryos were slow-frozen and stored until the women were cured and able to undergo embryo transfer. RESULTS Fifty-four women underwent 66 oocyte pick-up procedures in total, and embryos were obtained from 52 of the 54 patients. Four patients died before their frozen embryos could be thawed. Of the remaining 48, 9 women returned to use their embryos, resulting in 6 pregnancies (66% cumulative pregnancy rate), two of which ended in miscarriage. The live birth rate per patient was thus 44% (4/9). The true come-back rate, calculated after applicable exclusions, was found to be 23%. CONCLUSION IVF followed by embryo freezing is a widely established technique for fertility preservation, but little has been published on the outcomes in cancer patients. While we found the number of good-quality embryos to be lower than in a normal population, the cumulative live birth rate was similar to that achieved with fresh embryos in non-cancer patients. The utilization rate of this fertility preservation method can be considered high.
Collapse
Affiliation(s)
- M M Dolmans
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC) and Cliniques Universitaires Saint-Luc, Gynecology Department, Université Catholique de Louvain, Avenue Mounier 52 bte B1.52.02, B-1200, Woluwe-Saint-Lambert, Brussels, Belgium,
| | | | | | | |
Collapse
|
20
|
Tomlinson M, Meadows J, Kohut T, Haoula Z, Naeem A, Pooley K, Deb S. Review and follow-up of patients using a regional sperm cryopreservation service: ensuring that resources are targeted to those patients most in need. Andrology 2015; 3:709-16. [PMID: 26084986 DOI: 10.1111/andr.12045] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 04/02/2015] [Accepted: 04/06/2015] [Indexed: 01/25/2023]
Abstract
Are all patients undergoing chemotherapy for long-term sperm banking at risk of permanent sterility? Male fertility is generally lower in men with cancer and all patient groups are at risk of azoospermia. Careful management is required to ensure that samples are not stored for excessively long periods should they not be required. A retrospective analysis of 1688 patient records and prospective recall of patients for semen testing were performed. Pre-therapy fertility was compared with a group of pre-vasectomy patients as a comparator. Those who fail to bank spermatozoa, rates of disposal of samples and the utilization in assisted reproduction were also examined. Sperm quality was poorest in testicular cancer (TC) patients followed by those with Hodgkin's lymphoma (HL) prior to treatment. Post-therapy data were available in 376 patients (42%). Sperm number was lowest (and azoospermia highest at 77%) in patients with HL treated with regimens other than adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). Non-HL NHL and leukaemic patients had similarly high rates of azoospermia at 46 and 55%. HL patients treated with ABVD (11%) and TC patients (9.7%) had the lowest rates of azoospermia. Azoospermia was seen in every treatment group except for TC patients receiving carboplatin. Only 45 patients used their samples in ART (4.5%) in 10 years. Little is known about the fertility status of the patients not coming forward for follow-up testing, those conceiving naturally, those with no intention of conceiving and some which may have psychological reasons for not attending. In conclusion, virtually all patients undergoing chemotherapy are potentially at risk of temporary or permanent infertility. However, as uptake and utilization of stored material remain low, sperm banks should be carefully managed to ensure that resources are targeted to the patients most in need.
Collapse
Affiliation(s)
- M Tomlinson
- Fertility Unit, Nottingham University Hospital, Nottingham, UK.,Department of Clinical Sciences, Nottingham University Hospital, University of Nottingham, Nottingham, UK
| | - J Meadows
- Fertility Unit, Nottingham University Hospital, Nottingham, UK
| | - T Kohut
- Fertility Unit, Nottingham University Hospital, Nottingham, UK
| | - Z Haoula
- Department of Clinical Sciences, Nottingham University Hospital, University of Nottingham, Nottingham, UK
| | - A Naeem
- Computer Science Department, AIR University, Islamabad, Pakistan
| | - K Pooley
- Fertility Unit, Nottingham University Hospital, Nottingham, UK
| | - S Deb
- Fertility Unit, Nottingham University Hospital, Nottingham, UK.,Department of Clinical Sciences, Nottingham University Hospital, University of Nottingham, Nottingham, UK
| |
Collapse
|
21
|
Abstract
During the past decade, advances in cancer treatment have increased survival rates of both boys and men. However, cancer treatment itself can compromise fertility, especially exposure to alkylating agents and whole body irradiation, which cause substantial germ cell loss. Children and adolescents with testicular cancer, leukaemia, and Ewing sarcomas are at the highest risk of developing permanent sterility from cancer treatment. Consequently, various strategies to preserve fertility are necessary. Sperm cryopreservation is an effective but underused method to safeguard spermatozoa. In the past few years, large advances have been made in prepubertal germ cell storage aimed at subsequent transplantation of testicular tissue and associated stem cells. Although still experimental, these approaches offer hope to many men in whom germ cell loss is associated with sterility. The derivation of male gametes from stem cells also holds much promise; however, data are only available in animals, and the use of this method in human beings is probably many years away.
Collapse
Affiliation(s)
- Herman Tournaye
- Centre for Reproductive Medicine, University Hospital of the Free University Brussels, Brussels, Belgium.
| | - Gert R Dohle
- Andrology Unit, Department of Urology, Erasmus MC, Rotterdam, Netherlands
| | - Christopher L R Barratt
- Reproductive and Developmental Biology, Medical School, Ninewells Hospital, University of Dundee, Dundee, UK
| |
Collapse
|
22
|
Pacey AA, Merrick H, Arden-Close E, Morris K, Tomlinson M, Rowe R, Eiser C. How do men in the United Kingdom decide to dispose of banked sperm following cancer treatment? HUM FERTIL 2014; 17:285-8. [DOI: 10.3109/14647273.2014.947333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
23
|
Eiser C, Merrick H, Arden-Close E, Morris K, Rowe R, Pacey AA. Why don't some men with banked sperm respond to letters about their stored samples? HUM FERTIL 2014; 17:278-84. [PMID: 24946139 DOI: 10.3109/14647273.2014.922703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Long-term storage of banked sperm, especially when it is not needed, for reproductive purposes, is costly and poses practical problems for sperm banks. For sperm banks to function efficiently, men must understand the implications of unnecessary storage, and make timely decisions about disposal of their own samples. Men who bank sperm prior to cancer treatment are routinely offered follow-up consultations to test their fertility, update consent and, where necessary, expedite referral for Assisted Conception. Yet sperm banks report that men do not respond to letters, suggesting samples are stored needlessly. We conducted semi-structured interviews with six men with a history of not responding to letters, to document reasons for non-response. Interviews were transcribed and analysed using Interpretive Phenomenological Analysis. Men's reasons for not responding are a complex interplay between past, present and future perspectives. In terms of their past, information is important on diagnosis, because men must understand that fertility can change after treatment. Present and future concerns focus on fears of being told fertility has not recovered and being pressured to dispose of banked sperm. The challenge is to devise invitation letters that address men's concerns while offering them tangible benefits and peace of mind.
Collapse
Affiliation(s)
- Christine Eiser
- Department of Psychology, University of Sheffield , Sheffield , UK
| | | | | | | | | | | |
Collapse
|
24
|
Schover LR, van der Kaaij M, van Dorst E, Creutzberg C, Huyghe E, Kiserud CE. Sexual dysfunction and infertility as late effects of cancer treatment. EJC Suppl 2014; 12:41-53. [PMID: 26217165 PMCID: PMC4250536 DOI: 10.1016/j.ejcsup.2014.03.004] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 03/26/2014] [Indexed: 01/08/2023] Open
Abstract
Sexual dysfunction is a common consequence of cancer treatment, affecting at least half of men and women treated for pelvic malignancies and over a quarter of people with other types of cancer. Problems are usually linked to damage to nerves, blood vessels, and hormones that underlie normal sexual function. Sexual dysfunction also may be associated with depression, anxiety, relationship conflict, and loss of self-esteem. Innovations in cancer treatment such as robotic surgery or more targeted radiation therapy have not had the anticipated result of reducing sexual dysfunction. Some new and effective cancer treatments, including aromatase inhibitors for breast cancer or chemoradiation for anal cancer also have very severe sexual morbidity. Cancer-related infertility is an issue for younger patients, who comprise a much smaller percentage of total cancer survivors. However, the long-term emotional impact of being unable to have a child after cancer can be extremely distressing. Advances in knowledge about how cancer treatments may damage fertility, as well as newer techniques to preserve fertility, offer hope to patients who have not completed their childbearing at cancer diagnosis. Unfortunately, surveys in industrialised nations confirm that many cancer patients are still not informed about potential changes to their sexual function or fertility, and all modalities of fertility preservation remain underutilised. After cancer treatment, many patients continue to have unmet needs for information about restoring sexual function or becoming a parent. Although more research is needed on optimal clinical practice, current studies suggest a multidisciplinary approach, including both medical and psychosocial treatment options.
Collapse
Affiliation(s)
- Leslie R. Schover
- Department of Behavioral Science, Unit 1330, University of Texas MD Anderson Cancer Center, PO Box 301439, Houston, TX 77230-1439, USA
| | - Marleen van der Kaaij
- Department of Internal Medicine, ZH 4A 35, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Eleonora van Dorst
- Department of Reproductive Medicine and Gynaecological Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Carien Creutzberg
- Department of Clinical Oncology, Leiden University Medical Center, K1-P, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Eric Huyghe
- Service d’Urologie et d’Andrologie, Hopital Rangueil, 1, avenue Jean Poulhes, TSA 50032, 31059 Toulouse Cedex 9, France
| | - Cecilie E. Kiserud
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
25
|
Pacey AA, Eiser C. The importance of fertility preservation in cancer patients. Expert Rev Anticancer Ther 2014; 14:487-9. [PMID: 24506112 DOI: 10.1586/14737140.2014.883283] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The potential risks of anti-cancer therapy for male and female fertility are well understood, yet evidence suggests that fewer patients than predicted actually preserve their fertility before therapy begins. Studies of post-pubertal males and females suggest that the approach of health professionals in oncology is vital in facilitating successful sperm and egg banking. For men, this seems to be compounded by a general lack of understanding about their personal risk of infertility. Those involved in delivering anticancer therapy therefore have a vital role to play in providing timely information and facilitating efficient referral to fertility services. In the future, this is likely to become more important if new fertility preservation strategies such as ovarian and testicular tissue banking become more routinely used, with implications for both pre- and post-pubertal individuals.
Collapse
Affiliation(s)
- Allan Anthony Pacey
- University of Sheffield - Human Metabolism, Level 4, The Jessop Wing Tree Root Walk, Sheffield S10 2SF, UK
| | | |
Collapse
|
26
|
Sperm cryopreservation before testicular cancer treatment and its subsequent utilization for the treatment of infertility. ScientificWorldJournal 2014; 2014:575978. [PMID: 24587730 PMCID: PMC3919096 DOI: 10.1155/2014/575978] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 11/07/2013] [Indexed: 11/17/2022] Open
Abstract
Aims. In this study we report our results with storage of cryopreserved semen intended for preservation and subsequent infertility treatment in men with testicular cancer during the last 18 years. Methods. Cryopreserved semen of 523 men with testicular cancer was collected between October 1995 and the end of December 2012. Semen of 34 men (6.5%) was used for fertilization of their partners. They underwent 57 treatment cycles with cryopreserved, fresh, and/or donor sperm. Results. A total of 557 men have decided to freeze their semen before cancer treatment. Azoospermia was diagnosed in 34 men (6.1%), and semen was cryopreserved in 532 patients. Seminoma was diagnosed in 283 men (54.1%) and nonseminomatous germ cell tumors in 240 men (45.9%). 34 patients who returned for infertility treatment underwent 46 treatment cycles with cryopreserved sperm. Totally 16 pregnancies were achieved, that is, 34.8% pregnancy rate. Conclusion. The testicular cancer survivors have a good chance of fathering a child by using sperm cryopreserved prior to the oncology treatment, even when it contains only limited number of spermatozoa.
Collapse
|
27
|
Implications of sperm banking for health-related quality of life up to 1 year after cancer diagnosis. Br J Cancer 2013; 108:1004-11. [PMID: 23470465 PMCID: PMC3619074 DOI: 10.1038/bjc.2013.57] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Sperm banking is recommended for all men diagnosed with cancer where treatment is associated with risk of long-term gonadatoxicity, to offer the opportunity of fatherhood and improved quality of life. However, uptake of sperm banking is lower than expected and little is known about why men refuse. Our aims were to determine: (i) demographic and medical variables associated with decisions about banking and (ii) differences in quality of life between bankers and non-bankers at diagnosis (Time 1 (T1)) and 1 year later (Time 2 (T2)). Methods: Questionnaires were completed by 91 men (response rate=86.67%) at T1 and 78 (85.71% response rate) at T2. Results: In all, 44 (56.41%) banked sperm. They were younger and less likely to have children than non-bankers. In a subset of men who were not sure if they wanted children in the future (n=36), 24 banked sperm. Among this group, those who banked were younger, more satisfied with clinic appointments and less worried about the health of future children. At T2, there were no differences in quality of life between bankers and non-bankers. Conclusion: For those who are uncertain about future reproductive plans, decisions depend on their health on diagnosis and satisfaction with clinic care. We conclude that extra care should be taken in counselling younger men who may have given little consideration to future parenting. Results support previous findings that the role of the doctor is vital in facilitating decisions, especially for those who are undecided about whether they wanted children in the future or not.
Collapse
|