Twenty years experience with semen cryopreservation in testicular cancer patients: who needs it?
OBJECTIVE
To evaluate the role of semen cryopreservation (SCP) in the fertility saving management of testicular cancer (TC) patients, treated at the Norwegian Radium Hospital between 1983 and 2002.


METHODS
422 of 1388 newly diagnosed TC patients had SCP All patients were followed up for post-treatment paternity.


RESULTS
During the 20 years study period, by 2002 an increasing percentage of patients had pre-treatment SCP, reaching 43% after 1994. Twenty-nine (7%) of the 422 patients with SCP had used their frozen semen for assisted reproductive techniques (ART) at least once to achieve fatherhood. Pregnancies were achieved in 16 of these patients' partners, but two of these pregnancies ended in abortions. 67(17%) of 393 men with SCP fathered at least one child without use of frozen semen. The comparable figures for those without SCP were 205 out of 966(21%). Twenty years after orchiectomy the cumulative incidence of first post-treatment fatherhood was 47% for the 393 patients who had SCP but did not use it for ART, and 34% for the 966 patients without SCP (p=0.12).


CONCLUSIONS
If offered, about 50% of the young and middle-aged patients newly diagnosed with TC are interested in pre-treatment SCP. Though our study reveals that a considerable number of TC patients referred to SCP, achieve fatherhood without the use of frozen semen, the psychological impact of pre-treatment cryopreservation is undeniable. Furthermore, for some TC survivors ART with cryopreserved sperm offers the only chance of post-treatment paternity.
Magelssen
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H
The Norwegian Radium Hospital, Dep of Clinical Research, Montebello, 0310 Oslo, Norway. henriette.magelsen@radiumhospitalet.no
Haugen
T B
TB
von Düring
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V
Melve
K K
KK
Sandstad
B
B
Fosså
S D
SD
D000293:Adolescent; D000328:Adult; D015925:Cryopreservation; D005260:Female; D006801:Humans; D007317:Insemination, Artificial, Homologous; D008297:Male; D008875:Middle Aged; D009664:Norway; D009919:Orchiectomy; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D012662:Semen Preservation / Q000523:psychology*; D013074:Sperm Banks / Q000706:statistics & numerical data; D013736:Testicular Neoplasms / Q000473:pathology / Q000523:psychology / Q000628:therapy