Electroejaculation as a method of fertility preservation in boys diagnosed with cancer: a single-center experience and review of the literature.
OBJECTIVE
To evaluate the feasibility of electroejaculation to perform semen cryopreservation in pubertal boys before gonadotoxic therapy and to review the literature on this topic.


METHODS
Retrospective cohort study and review of the literature.


METHODS
Academic children's hospital.


METHODS
Boys diagnosed with cancer to whom sperm cryopreservation was offered before the start of gonadotoxic therapy.


METHODS
We studied the outcome of electroejaculation, including patient characteristics, hormone levels, and pretreatment semen parameters.


METHODS
Semen cryopreservation.


RESULTS
Pretreatment semen samples were obtained by masturbation in 106/114 boys with cancer, of which 78/106 were adequate for preservation. Electroejaculation was offered to 11 boys, of which three of 11 samples appeared adequate for preservation. Reviewing all reported electroejaculation cases in children with cancer in the literature, 13/29 (45%) cases were successful. Testosterone levels were higher in patients with successful sperm yield obtained by electroejaculation (median, 8.3 nmol/L [5.2-42.4] in successful harvests, vs. median 1.7 nmol/L [0.01-17.9] in unsuccessful harvests).


CONCLUSIONS
Semen cryopreservation should be offered to all pubertal boys diagnosed with cancer. If masturbation fails, electroejaculation can be considered as a useful option for semen cryopreservation and leads to adequate material for cryopreservation in about half of the cases.
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
Maria C
MC
Adank
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.
Wendy
W
van Dorp
Division of Andrology, Department of Urology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.
Marij
M
Smit
Division of Andrology, Department of Urology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.
Niels J
NJ
van Casteren
Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.
Joop S E
JS
Laven
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
Rob
R
Pieters
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. Electronic address: m.vandenheuvel@erasmusmc.nl.
Marry M
MM
van den Heuvel-Eibrink
D000293:Adolescent; D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D015925:Cryopreservation; D004542:Ejaculation; D004558:Electric Stimulation; D005240:Feasibility Studies; D059247:Fertility Preservation / Q000379:methods*; D006776:Hospitals, Pediatric; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008418:Masturbation; D009369:Neoplasms / Q000628:therapy*; D009426:Netherlands; D011627:Puberty; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D055101:Semen Analysis; D012662:Semen Preservation; D013997:Time Factors
D000970:Antineoplastic Agents
Sperm cryopreservation; childhood cancer; electroejaculation; infertility