title: Sperm cryopreservation and reproductive outcome in male cancer patients: a systematic review.
abstract: This systematic review of the literature reports on the use and effectiveness of sperm banking programmes for cancer patients. Thirty studies with 11798 patients were included. The aggregated rate of use of cryopreserved semen was 8% (95% CI 8 to 9%). A statistically significant correlation emerged between the mean and median duration of follow-up and the rate of use (R(2) = 0.46; P = 0.03). The rate of patients discarding their frozen sample was reported in 11 studies. The aggregated rate was 16% (95% CI 15 to 17%). The rate of patients who used their frozen semen and achieved parenthood was reported in 19 papers. The aggregated rate was 49% (95% CI 44 to 53%). The rate of patients achieving parenthood with the use of frozen sperm is low and, from an economical perspective, the effectiveness of programmes of sperm banking might therefore be questioned. On the other hand, the low rate of patients discarding their frozen samples and the correlation between rate of use and duration of follow-up suggest that the calculated 8% rate of use may be an under-estimation and that cumulative rate of use may be substantially higher. Specific studies are, however, required to clarify this issue.
authors.affiliation: Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Infertility Unit, via M. Fanti 6, 20122 Milan, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Ferrari
authors.affiliation: Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Infertility Unit, via M. Fanti 6, 20122 Milan, Italy. Electronic address: alessio.paffoni@policlinico.mi.it.
authors.forename: Alessio
authors.initials: A
authors.lastname: Paffoni
authors.affiliation: Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Infertility Unit, via M. Fanti 6, 20122 Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Filippi
authors.affiliation: Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Infertility Unit, via M. Fanti 6, 20122 Milan, Italy; Università degli Studi di Milan, Obstetrics and Gynecology, via Commenda 10, 20122 Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Busnelli
authors.affiliation: Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Infertility Unit, via M. Fanti 6, 20122 Milan, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Vegetti
authors.affiliation: Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Infertility Unit, via M. Fanti 6, 20122 Milan, Italy.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
mesh_terms: D000293:Adolescent; D000328:Adult; D001723:Birth Rate; D015925:Cryopreservation; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000503:physiopathology; D011247:Pregnancy; D018873:Pregnancy Rate; D012098:Reproduction; D012661:Semen; D012662:Semen Preservation; D013074:Sperm Banks; D013094:Spermatozoa / Q000473:pathology; D055815:Young Adult
keywords: assisted reproductive techniques; cancer; cryopreservation; fertility preservation; semen preservation; sperm banks