Intracytoplasmic sperm injection (ICSI) using cryopreserved sperm from men with malignant neoplasm yields high pregnancy rates

Hourvitz, Ariel; Goldschlag, Dan E.; Davis, Owen K.; Gosden, Lucinda Veeck; Palermo, Gianpiero D.; Rosenwaks, Zev

doi:10.1016/j.fertnstert.2007.03.002

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Volume 90, Issue 3 , Pages 557-563, September 2008

Intracytoplasmic sperm injection (ICSI) using cryopreserved sperm from men with malignant neoplasm yields high pregnancy rates

Ariel Hourvitz, M.D., M.H.A.
- IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University New York Presbyterian Hospital, New York, New York
Dan E. Goldschlag, M.D.
- Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University New York Presbyterian Hospital, New York, New York
Owen K. Davis, M.D.
- Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University New York Presbyterian Hospital, New York, New York
Lucinda Veeck Gosden, D.Sc. (Hon.)
- Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University New York Presbyterian Hospital, New York, New York
Gianpiero D. Palermo, M.D., Ph.D.
- Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University New York Presbyterian Hospital, New York, New York
Zev Rosenwaks, M.D.
- Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University New York Presbyterian Hospital, New York, New York
- Reprint requests: Zev Rosenwaks, M.D., Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, New York (FAX: 212-746-1861).

Received 22 November 2006; received in revised form 2 March 2007; accepted 2 March 2007. published online 11 August 2008.

Objective

To investigate the efficacy of IVF–intracytoplasmic sperm injection (ICSI) in patients who cryobanked semen before cancer treatment.

Design

Retrospective consecutive study.

Setting

University-based IVF unit.

Patient(s)

One hundred eighteen couples undergoing IVF-ICSI using pretreatment frozen sperm.

Intervention(s)

Treatment follow-up.

Main Outcome Measure(s)

Semen parameters and clinical pregnancy rates.

Result(s)

One hundred eighteen couples underwent 169 IVF cycles using pretreatment cryopreserved sperm; the average sperm count was 66.5 × 10⁶/mL, and the average motility was 45.6%. Post-thaw sperm average density was 40.9 × 10⁶/mL with 14.2% motility. The clinical pregnancy rate was 56.8% per retrieval; 96 pregnancies were achieved, resulting in 126 children born and 11 spontaneous abortions. Patients with prostate cancer had the worst semen parameters before sperm banking and the lowest clinical pregnancy rates.

Conclusion(s)

IVF-ICSI is the recommended treatment for most couples with cryopreserved sperm for male cancer. High pregnancy and delivery rates after IVF-ICSI using cryopreserved sperm from patients with cancer should encourage all reproductive-age males to cryobank semen immediately after diagnosis; physicians should discuss this and advise freezing multiple samples before treatment.

Key Words: IVF, ICSI, male cancer, sperm, cryobanking