Pretreatment Semen Parameters in Men With Cancer

University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
The Journal of urology (Impact Factor: 4.47). 02/2009; 181(2):736-40. DOI: 10.1016/j.juro.2008.10.023
Source: PubMed


Whether the presence or specific type of cancer significantly affects semen quality is controversial. We evaluated the semen parameters and associated malignancies of men with cancer who cryopreserved sperm at our institution before undergoing therapy.
We reviewed the database from our cryopreservation laboratory during a 5-year period. Office charts of 409 of 1,409 patients were available for review. Age at banking, semen volume, sperm density, percent motile sperm and type of cancer were recorded. Semen parameters were compared to values for fertile and subfertile men established by the National Cooperative Reproductive Medicine Network as well as from a large local pre-vasectomy cohort to consider geographic variations.
A total of 717 semen samples from 409 men included 45% with testicular cancer, 10% with Hodgkin's lymphoma, 7% with nonHodgkin's lymphoma, 6% with sarcoma, 6% with prostate cancer, 5% with leukemia, 3% with gastrointestinal cancer and 2% with central nervous system tumors. Of these men 16% had unspecified or other rare malignancies. Mean patient age was 29.9 years (range 11.9 to 87.7), mean semen volume was 2.8 ml (range 0.1 to 15.0), mean sperm density was 47.4 x 10(6)/ml (range 0.1 to 320) and mean sperm motility was 50.0% (range 1% to 90%). For men with testicular cancer sperm density and motility were in the intermediate range. Parameters for men with all other malignancies were in the fertile range for density and intermediate range for motility.
Men with most types of cancer have pretreatment semen parameters in the fertile range for density and in the intermediate range for motility. However, men with testicular cancer statistically have lower semen quality compared to those with other malignancies. These findings further highlight the importance of pretreatment fertility preservation in this patient population before undergoing gonadotoxic treatments.

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    • "Sauf chez les hommes ayant un cancer du testicule, la qualité des spermogrammes des hommes ayant un cancer était dans les normes de fertilité pour le volume (2,8 mL) et la numération (47 x 106/mL), et intermédiaire pour la mobilité (50 %). Pour les 24 patients qui avaient un cancer de prostate, d'âge moyen de 52 ans, le volume moyen était de 2,8 mL, la numération de 83 millions/mL et la mobilité de 50 % [60]. "
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    ABSTRACT: All treatments for prostate cancer have a negative impact on sexuality. The objective of this review is to highlight recent developments in the management of sexual dysfunction associated with prostate cancer. We performed a literature search in the Pubmed database to select relevant articles. There is a specific profile of changes in the fields of sexual, urinary, bowel and general quality of life, according to the treatment modalities chosen. Maintenance of a satisfying sex life is a major concern of a majority of men facing prostate cancer and its treatments. It is essential to assess the couple's sexuality before treating prostate cancer in order to deliver comprehensive information and consider early therapeutic solutions adapted to the couple's expectations. The results of randomized studies show that robotic radical prostatectomy allows a faster recovery of natural erections compared to classic laparoscopy. Active pharmacological erectile rehabilitation (intracavernous injections or phosphodiesterase type 5 inhibitors [PDE5i] on demand, during the month following surgery) or passive (daily PDE5i after surgery) might improve the quality of erections especially in response to PDE5i. Unimpaired aspects of sexual response (orgasm) may, when the erection is not yet recovered, represent an alternative allowing the couple to preserve intimacy and complicity. Androgen blockade is a major barrier to maintain or return to a satisfying sex. After the treatment of prostate cancer, one specific support sometimes assisted by networking will optimize satisfying sex life recovery.
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    • "Cancer control, urinary continence, and erectile function are the more concerning outcomes for patients [2]. However, there are reports of younger men with prostate cancer undergoing sperm cryopreservation and percutaneous epididymal sperm extraction (PESA) for intracytoplasmic sperm injection (ICSI) [3] [4] [5]. Patients with low or intermediate risk disease and thus a more favorable prognosis of cure from surgery alone might benefit from an attempt at concomitant preservation of continuity of the vas with the urinary tract in order to facilitate ease of sperm retrieval for future efforts of conception. "
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    ABSTRACT: Ease of sperm retrieval has not been previously described as a goal for patients undergoing radical prostatectomy for prostate cancer; however preservation of fertility is a known concern for some younger prostate cancer patients. We present the first known case of a patient with postejaculatory spermaturia following robotic assisted radical prostatectomy. We hypothesize that this is due to fistula formation between the vas deferens and the urinary tract.
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    • "The sperm concentration and total sperm number were normal in more than 40% and 50% of our patients respectively. Published data are also heterogeneous with regard to impaired parameters (Hendry et al, 1983; Agarwal and Newton, 1991; Kliesh et al, 1997; Petersen et al, 1999a,b; Bussen et al, 2004; Williams et al, 2009), normal parameters (Botchman et al, 1997; Sibert et al, 1999; Gandini et al, 2003; Ragni et al, 2003; Chung et al, 2004; Bahadur et al, 2005), and distribution similar to our data (Fossa et al, 1984; Padron et al, 1997; Reiter et al, 1998). The sperm concentration and total sperm number were significantly reduced after orchiectomy in our population. "
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