Reproductive technique shows promise in men with chemotherapy history

By Anthony J. Brown, MD

NEW YORK (Reuters Health) – Sperm can often be retrieved from men with azoospermia following chemotherapy for cancer, according to a recent report published in the February 15th issue of the Journal of Clinical Oncology. These sperm can then be used to establish pregnancy with intracytoplasmic sperm injection (ICSI).

Dr. Robert D. Oates, from Boston University, and colleagues assessed the outcomes of testis sperm extraction in 23 men with postchemotherapy azoospermia. In this procedure, "testicular parenchyma is removed, processed, and microscopically examined for spermatozoa."

Sperm were successfully retrieved from 15 men, the authors report. Twelve men underwent ICSI with their partners. For a total of 26 ICSI cycles, the average fertilization rate was 65.2% and the ongoing/delivery rate was 30.8%. Six healthy boys and four healthy girls have been delivered to date.

"We can now tell men who've had chemotherapy in the past that there is a chance that sperm can be retrieved," Dr. Oates told Reuters Health. "We didn't know this before," he added. "However, we're still not at the point where we can predict the likelihood of retrieving sperm based on the cancer type and the chemotherapy regimen used," he said.

"The second point is that if we find sperm, there is a good chance that they will actually work," Dr. Oates noted. "In the past, we didn't know if the azoospermia was due to destruction of a portion of spermatogonia cells or from permanent genetic damage to all the germ cells," he said. "The current findings suggest that the former mechanism is the cause," he added.

"The most important finding, at least for the couples involved, is that the children appeared to be healthy," Dr. Oates emphasized. "It's really a great outcome for all involved."

J Clin Oncol 2002;20:930-936.

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