Results of semen cryopreservation in young men with testicular carcinoma and lymphoma.

Abstract

Sixty-two young men with testicular carcinoma (31 patients) or lymphoma (31 patients) were referred for semen analysis and possible cryopreservation before systemic therapy. Seventy-seven percent of the patients, 24 patients with testicular carcinoma and 24 patients with lymphoma, had semen with a decreased chance for fertility (ie, sperm density less than 20 X 10(6)/mL and/or less than 40% motile sperm and/or decreased sperm motility). A decreased number of motile sperm as well as a poor grade of motility appeared in the majority of semen specimens from both patient groups. However, 14 patients had semen that met our criteria for fertility with sperm density greater than or equal 20 X 10(6)/mL, greater than or equal 40% motile sperm, and motility grade greater than 2. Semen quality appeared to be better in patients referred immediately after diagnosis than in patients in whom there was a delay between diagnosis and referral for semen cryopreservation. Twelve patients with semen meeting our criteria for possible fertility and 42 patients failing our criteria elected to cryopreserve semen. A median of three collections per patient were stored. To date, seven patients have withdrawn semen for artificial insemination by husband attempts, and two of these attempts have resulted in pregnancies. Both attempts involved patients with semen that meet our criteria for potential fertility. In the minority of young men with lymphoma or testicular carcinoma who have good-quality semen, semen cryopreservation can preserve reproductive potential after therapy that might otherwise cause sterility.