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International Journal of Clinical Oncology

Erschienen in:

15.06.2016 | Original Article

Microdissection testicular sperm extraction in Japanese patients with persistent azoospermia after chemotherapy

verfasst von: Takeshi Shin, Tomohiro Kobayashi, Yukihito Shimomura, Toshiyuki Iwahata, Keisuke Suzuki, Takashi Tanaka, Mai Fukushima, Megumi Kurihara, Akane Miyata, Yoshitomo Kobori, Hiroshi Okada

Erschienen in: International Journal of Clinical Oncology | Ausgabe 6/2016

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Abstract

Background

Combinations of surgery, radiation therapy, and chemotherapy can achieve high remission rates in patients with cancer, but these treatments can have damaging effects on spermatogenesis. In particular, cytotoxic chemotherapy may lead to irreversible spermatogenic dysfunction. Microdissection testicular sperm extraction (micro-TESE) is the only method that can address infertility in cancer survivors with persistent postchemotherapy azoospermia.

Methods

We included 66 Japanese patients with postchemotherapy azoospermia who underwent micro-TESE for sperm retrieval in this analysis. Age, oncology data, hormone profiles, and outcomes of micro-TESE and subsequent intracytoplasmic sperm injections (ICSIs) were reviewed.

Results

The common disease in our patients was testicular cancer (21 patients), followed by acute lymphoblastic leukemia and Hodgkin’s lymphoma (nine patients). In this cohort of 66 patients, sperm was successfully retrieved in 31 patients (47 %), and clinical pregnancy occurred in 23 cases (35 %). The live birth rate was 27 %. No significant differences in sperm retrieval, clinical pregnancy, and live birth rates were seen between testicular cancer, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia, or sarcoma cases. Multiple logistic regression analysis showed that the chance of retrieving sperm during micro-TESE could not be predicted by any variable.

Conclusions

Cryopreservation of sperm should be offered before any gonadotoxic chemotherapy takes place. However, micro-TESE and subsequent ICSI could be effective treatment options for patients with persistent postchemotherapy azoospermia whose sperm were not frozen before therapy. Our results suggest that micro-TESE-ICSI could benefit 27 % of such Japanese patients.

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Titel: Microdissection testicular sperm extraction in Japanese patients with persistent azoospermia after chemotherapy
verfasst von: Takeshi Shin
Tomohiro Kobayashi
Yukihito Shimomura
Toshiyuki Iwahata
Keisuke Suzuki
Takashi Tanaka
Mai Fukushima
Megumi Kurihara
Akane Miyata
Yoshitomo Kobori
Hiroshi Okada
Publikationsdatum: 15.06.2016
Verlag: Springer Japan
Erschienen in: International Journal of Clinical Oncology / Ausgabe 6/2016
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-016-0998-5

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Microdissection testicular sperm extraction in Japanese patients with persistent azoospermia after chemotherapy