Examination of clinical data and semen analysis results of patients undergoing orchiectomy for testicular tumor

Future perspectives of fertility protection

Reproductive health is of major importance for individuals, for the society and for the health of future generations. This includes physical and medical dimensions as well as psychosocial and ethical ones. Whenever the possibility of starting a family is compromised, either due to an oncological cytotoxic treatment or due to transgender hormone medication with the aim to align their secondary sexual characteristics or other medical or social conditions, one key aspect of reproductive health is fertility protection. However, as a very young field in medicine, there are still many research questions that need to be clarified to provide the best possible treatment for affected people. These include the optimization and safety of cryopreservation processes of germ cells in women, men, transgender people, adolescents and children. Another focus is on psychological care as well as ethical, economic and legal issues. The establishment and development of the center for fertility protection Ulm (FePro-Ulm) will focus on a detailed molecular biological and (epi)genetic understanding of the underlying processes in ovarian tissue, oocytes and sperm to improve and develop new diagnostic and therapeutic approaches. The individual needs of affected people, their partners and families will be evaluated by an interdisciplinary approach. The collaborations within FePro-Ulm will develop preventative and helpful interventions for affected people. In addition, a better awareness of this important topic of reproductive health and fertility protection will be addressed by including participation representatives and strengthen public relation works.

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

BACKGROUND

Sperm cryopreservation is an effective method of fertility preservation for disease-related and social sperm freezing. In total, 662 subjects (range: 15-65 years-of-age; mean: 33.49 ± 8.79 years-of-age) were included in this study to investigate the population characteristics, semen quality, and usage of autologous sperm preservation patients in Beijing. Of these, 351 were cancer patients (53.02%, 31.14 ± 7.32 years-of-age) and 311 were non-cancer patients (46.98%, 36.14 ± 9.54 years-of-age).

RESULTS

We found that the number of preservation cases increased steadily from 2015 to 2019; 89.73% of these had a bachelor's degree or above; 54.83%, 41.54%, and 3.63% were single, married, and divorced, respectively. The cases of cancers and oligozoospermia accounted for 71.30% of all patients; therefore, most patients required fertility preservation due to disease. The cancer group had a significantly lower sperm concentration, rate of progressive sperm after the frozen-thawed test, total progressive motility sperm count after the frozen-thawed test, and recovery rate of progressive motile sperm (RRPM) than the non-cancer group (all P < 0.05). Sperm count-related parameters were significantly affected by testicular cancer, while sperm motility-related parameters and RRPM were significantly affected by leukemia. The utilization rate of preserved sperm was 6.34% after 6 to 78 months of follow-up. In terms of fresh or frozen embryo transfer, the clinical pregnancy rate was 56.76% or 50.00%, and the live birth rate was 24.32% or 21.43%, respectively.

CONCLUSION

The need for autologous sperm preservation was dominated by patients with diseases, followed by the need for social sperm freezing. Tumors had a major negative impact on semen quality, and the usage rates of stored semen were at lower level compared to the number of sperm cryopreservation. Medical staff and patients should pay attention to both cognition-action consistency and cost-effectiveness in fertility preservation.