title: Semen quality of 4480 young cancer and systemic disease patients: baseline data and clinical considerations.
abstract: BACKGROUND
  Except for testicular cancer and Hodgkin's disease, baseline data on semen quality in case of cancers as well as systemic pathologies of the young adult are scarce or based on low sample size.
  
  
  METHODS
  Semen quality in patients having testicular cancer (TGCT, n = 2315), Hodgkin's disease (HD, n = 1175), non-Hodgkin's lymphoma (NHL, n = 439), leukemia (L, n = 360), sarcoma (S, n = 208), brain tumour (BT, n = 40), Behcet's disease (Behcet's, n = 68) or multiple sclerosis (MS, n = 73) was studied and compared to that of 1448 fertile men candidates for sperm donation (CSD) and 208 partners of pregnant women (PPW). All samples were studied following the same methodology in a single laboratory. Post freezing and thawing semen characteristics were also studied.
  
  
  RESULTS
  The percentage of normozoospermic men was only 37 % for L patients and lower than 60 % for TGCT, NHL, S and BT. The level of sperm production was differently decreased according to pathologies, the median total sperm count in TC and L patients being four times lower (p < 0.01 when compared to CSD and PPW). The lowest percentage of progressively motile spermatozoa was found for L and BT patients (both, p < 0.01 compared to CSD and PPW). The percentage of morphologically normal spermatozoa was also reduced in cancer patients, especially in BT patients. Progressive motility after thawing in patients was about half that observed among candidates for sperm donation. In almost half of the semen of patients with testicular cancer or leukemia, the total number of motile spermatozoa per straw was less than 0.5 × 10(6) compared to 4.3 × 10(6) in CSD.
  
  
  CONCLUSIONS
  The present data confirm on large series the deleterious impact of various cancers of the young adult on semen quality, establishing thus baseline data for future studies. Owing to the post-thaw quality of the frozen straws, future fertility projects for the majority of the patients studied (in case there is no post-treatment recovery of spermatogenesis) should necessitate an ICSI to provide the best chance of paternity whatever the fertility check-up in the female partner.
authors.affiliation: Service d'Histologie-Embryologie, Biologie de la Reproduction/CECOS, Hôpitaux Universitaires Paris Centre, Site Port-Royal, 53, Avenue de l'Observatoire, 75014 Paris, France ; INSERM U1016, Equipe "Génomique, Epigénétique et Physiologie de la Reproduction", Institut Cochin, Université Paris Descartes, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Auger
authors.affiliation: Service d'Histologie-Embryologie, Cytogénétique, Biologie de la Reproduction/CECOS, Hôpitaux Universitaires Paris Seine-Saint-Denis, Site Jean Verdier, 93143 Bondy, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Sermondade
authors.affiliation: Service d'Histologie-Embryologie, Cytogénétique, Biologie de la Reproduction/CECOS, Hôpitaux Universitaires Paris Seine-Saint-Denis, Site Jean Verdier, 93143 Bondy, France ; INSERM U1016, Equipe "Génomique, Epigénétique et Physiologie de la Reproduction", Institut Cochin, Université Paris Descartes, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Eustache
keywords: Assisted reproductive technologies; Cancer; Semen quality; Sperm banking; Sperm cryopreservation; Systemic disease