Assessing the Impact of Male Cancers on Total Motile Sperm Count

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II (PD25)1 Apr 2020PD25-05 ASSESSING THE IMPACT OF MALE CANCERS ON TOTAL MOTILE SPERM COUNT Tharu Tharakan, Miles Smith*, Thomas Stroud, Ee Teng Goh, Monica Figueiredo, Lia Joannou, Chey Dearing, Lona Vyas, Channa Jayasena, Jonathan Ramsay, and Suks Minhas Tharu TharakanTharu Tharakan More articles by this author , Miles Smith*Miles Smith* More articles by this author , Thomas StroudThomas Stroud More articles by this author , Ee Teng GohEe Teng Goh More articles by this author , Monica FigueiredoMonica Figueiredo More articles by this author , Lia JoannouLia Joannou More articles by this author , Chey DearingChey Dearing More articles by this author , Lona VyasLona Vyas More articles by this author , Channa JayasenaChanna Jayasena More articles by this author , Jonathan RamsayJonathan Ramsay More articles by this author , and Suks MinhasSuks Minhas More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000882.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Improvements in cancer survival rates have led to an increased focus on survivorship programmes, including fertility preservation. Whilst the gonadotoxic effect of oncological therapy is widely recognised, emerging evidence suggests that spermatogenesis is impaired in men even prior to treatment. However, the effects of different cancer types on spermatogenic function remain unknown. Total Motile Count (TMC) has emerged as a prognostic indicator of fertility potential, yet there remains very little data reporting the effects of male cancers on TMC. The aim of this study was to assess the effects of male cancers on TMC. METHODS: An analysis of male patients with cancer undergoing sperm cryopreservation at a UK tertiary centre between 1992-2016. Primary measures were semen parameters prior to cryopreservation, including TMC. TMC was calculated: [semen volume]*[sperm concentration]*[total motility]. Patients were categorised according to their cancer diagnosis: testicular, prostate, leukaemia, lymphoma, gastrointestinal, brain and other cancers. Kruskal-Wallis tests with Dunn’s pairwise post-hoc analyses were performed to compare variables between groups, and Bonferroni corrections applied to p-values. Chi-squared tests were used to compare proportions between groups. RESULTS: 3433 cancer patients cryopreserved sperm during the study period. Testicular malignancy was the most frequent indication for sperm cryopreservation. Overall, 30.8% of men cryopreserving sperm had an abnormal sperm concentration. Testicular malignancy was associated with the lowest sperm concentration (p<0.001) and the greatest prevalence of oligozoospermia (<15 x 106mL-1) (p<0.001). Patients with leukaemia had the lowest sperm motility (p<0.001). Overall, 29.3% of male cancer patients had an abnormal TMC (<20 x 106). Patients with testicular malignancy had the lowest TMC of all cancer types (p<0.001). 34.4% had less than 20 million motile sperm in their ejaculate, including 13.4% (n=144) who had a TMC <5 million. CONCLUSIONS: This study represents the largest single-centre analysis of sperm cryopreservation in men with cancer. We highlight that, according to their TMC, almost 30% of male cancer patients are subfertile before their cancer treatment. Whilst men with testicular malignancy are the most severely affected, a significant proportion of men with all cancer types would likely require the use of Assisted Reproductive Technologies to achieve successful conception (as indicated by TMC <20 million) even prior to potentially gonadotoxic therapy. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e539-e540 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tharu Tharakan More articles by this author Miles Smith* More articles by this author Thomas Stroud More articles by this author Ee Teng Goh More articles by this author Monica Figueiredo More articles by this author Lia Joannou More articles by this author Chey Dearing More articles by this author Lona Vyas More articles by this author Channa Jayasena More articles by this author Jonathan Ramsay More articles by this author Suks Minhas More articles by this author Expand All Advertisement PDF downloadLoading ...