Abstract 1406

Okada, Hiroshi et al

Patients with azoospermia which is the result of chemotherapy have presented a therapeutic challenge to the urologist. Unfortunately, not all patients with malignancy have been offered cryopreservation of sperm. The failure to offer this option to patients is based upon the knowledge that many patients with testicular malignancies or non urologic malignancies have abnormal spermatogenesis. Before the widespread availability of assisted reproductive technologies, these patients were not advised to cryopreserve sperm since they were thought to have poor reproductive potential. However, IVF and ICSI have dramatically improved the prognosis for these patients. The presence of any sperm is an indication for cryopreservation. Nevertheless, there are patients who have not been afforded this opportunity. These patients have traditionally been thought to have not therapeutic options other than donor insemination or adoption. The authors demonstrate that a significant number of patients who became azoospermic after chemotherapy for a variety of malignancies including testicular cancer will have sperm that can be identified by testicular sperm acquisition techniques. 35 patients were reported with various primary malignancies (10 testicular, 5 non Hodgkin's Lymphoma, 5 acute lymphoblastic leukemia, 4 acute myeloblastic leukemia, 3 rhadomyosarcoma and 4 patients with bone marrow transplant and chemotherapy. The mean time since chemotherapy was 8 years. Sperm was retrieved from the testicles of 13 patients. Chemical pregnancy was achieved in 9 patients and 7 live deliveries were achieved. More than 40% of patients with longstanding azoospermia after chemotherapy have sperm available to achieve pregnancy.

EDITORIAL COMMENT:

This abstract demonstrates the ability to retrieve sperm in azoospermic men after chemotherapy. In spite of this success, all patients who are to undergo chemotherapy for urologic or non urologic malignancies should be offered cryopreservation. However, if they have not store sperm attempted testicular sperm extraction can be offered with good success.

Written by Harris M. Nagler, MD, a Contributing Editor with UroToday.

Please log-in or register in order to submit comments.

Powered by AkoComment!