Testicular sperm extraction for fertility preservation in young patients with cancer.

IF 1.7 3区 医学 Q4 ANDROLOGY Translational andrology and urology Pub Date : 2024-08-31 Epub Date: 2024-08-26 DOI:10.21037/tau-24-21
Jurii Karibe, Teppei Takeshima, Shinnosuke Kuroda, Daiji Takamoto, Takashi Kawahara, Kimito Osaka, Jun-Ichi Teranishi, Mariko Murase, Kazuhide Makiyama, Hiroji Uemura, Yasushi Yumura
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Abstract

Background: Cancer survivors in the adolescent and young adult generation often experience marriage, pregnancy, and childbirth after treatment; thus, fertility preservation is very important. In male patients, testicular sperm extraction (TESE) is sometimes performed due to azoospermia. Such a procedure is called oncological TESE (onco-TESE). In the present study, we aimed to define onco-TESE as TESE for fertility preservation in cancer patients, including those receiving gonadotoxic treatment.

Methods: Seventeen male patients with cancer who had undergone onco-TESE for fertility preservation at Yokohama City University Medical Center between April 2014 and March 2023 were included in the study.

Results: Motile testicular sperm were acquired by TESE in 9 out of 17 cases. Among patients who had initiated chemotherapy before surgery, Motile sperm could be acquired by onco-TESE in 3 out of 9 cases. In chemotherapy-naive patients, Motile sperm were acquired by onco-TESE in 6 out of 8 cases. In the end, sperm cryopreservation was performed in 10 patients. Cryopreserved sperm were used in 2 of the 10 cases, and live birth was achieved after intracytoplasmic sperm injection in both cases.

Conclusions: Before starting gonadotoxic treatment, it is important to confirm whether the patient desires to bear children. If having a baby is desired, a referral to a reproductive medicine doctor is recommended. Fertility preservation before starting gonadotoxic treatment is preferable, but fertility preservation could be considered even after such a treatment.

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为年轻癌症患者提取睾丸精子以保留生育能力。
背景:青少年和青年一代的癌症幸存者往往在治疗后经历结婚、怀孕和生育,因此,保留生育能力非常重要。男性患者有时会因无精子症而进行睾丸取精术(TESE)。这种手术被称为肿瘤学 TESE(onco-TESE)。在本研究中,我们旨在将onco-TESE定义为癌症患者(包括接受性腺毒性治疗的患者)保留生育能力的TESE:研究纳入了 17 名男性癌症患者,他们于 2014 年 4 月至 2023 年 3 月期间在横滨市立大学医疗中心接受了 onco-TESE 用于保留生育能力:结果:17 例患者中有 9 例通过 TESE 获得了有活力的睾丸精子。在手术前已开始化疗的患者中,9 例中有 3 例可通过onco-TESE 获得活动精子。在未接受化疗的患者中,8 例中有 6 例可通过onco-TESE获得活动精子。最后,对 10 例患者进行了精子冷冻保存。10 例患者中有 2 例使用了冷冻保存的精子,这 2 例患者都在卵胞浆内单精子注射后获得了活产:结论:在开始性腺毒性治疗之前,必须确认患者是否希望生育。如果希望生育,建议转诊至生殖医学医生。最好在开始性腺毒性治疗前保留生育能力,但即使在治疗后也可以考虑保留生育能力。
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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
80
期刊介绍: ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.
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