Natural and Assisted Conceptions in Male Patients With Blood Cancers Who Stored Their Semen for Fertility Preservation.

Abstract

Purpose: The recent improvement in the prognosis of blood cancers has focused attention toward fertility preservation. We aimed to provide real-world insights into sperm quality and rate of conception, both naturally and through assisted reproductive technology (ART), in men who stored their semen before treatments for hematologic cancers.

Materials and methods: Patients with hematologic cancer who cryopreserved semen between 1987 and 2018 had a postbanking follow-up and survived for at least 5 years after therapies were included. A total of N = 464 patients were selected.

Results: Overall, n = 407 survived and n = 255 (63%) underwent a post-treatment sperm analysis, revealing azoospermia in 37% of them. Severe or very severe impairment of spermatogenesis was significantly more prevalent in men affected by leukemias than by lymphomas. About half of cancer survivors (n = 200) sought fatherhood. Seventy-three achieved a natural live birth (37%). Forty-six percent of individuals seeking pregnancy used their cryopreserved samples in ART cycles, resulting in at least one live birth in 52% of them. Overall, 120 of 200 men (60%; 95% CI, 53 to 67) interested in fatherhood successfully had a live birth.

Conclusion: Treatments for hematologic cancer have a detrimental impact on semen quality. Semen preserved before therapies and ART are critical for fulfilling the common desire of parenthood in hematologic cancer survivors.