Pretreatment Semen Parameters in Men With Cancer

Abstract

Whether the presence or specific type of cancer significantly affects semen quality is controversial. We evaluated the semen parameters and associated malignancies of men with cancer who cryopreserved sperm at our institution before undergoing therapy. We reviewed the database from our cryopreservation laboratory during a 5-year period. Office charts of 409 of 1,409 patients were available for review. Age at banking, semen volume, sperm density, percent motile sperm and type of cancer were recorded. Semen parameters were compared to values for fertile and subfertile men established by the National Cooperative Reproductive Medicine Network as well as from a large local pre-vasectomy cohort to consider geographic variations. A total of 717 semen samples from 409 men included 45% with testicular cancer, 10% with Hodgkin's lymphoma, 7% with nonHodgkin's lymphoma, 6% with sarcoma, 6% with prostate cancer, 5% with leukemia, 3% with gastrointestinal cancer and 2% with central nervous system tumors. Of these men 16% had unspecified or other rare malignancies. Mean patient age was 29.9 years (range 11.9 to 87.7), mean semen volume was 2.8 ml (range 0.1 to 15.0), mean sperm density was 47.4 × 10⁶/ml (range 0.1 to 320) and mean sperm motility was 50.0% (range 1% to 90%). For men with testicular cancer sperm density and motility were in the intermediate range. Parameters for men with all other malignancies were in the fertile range for density and intermediate range for motility. Men with most types of cancer have pretreatment semen parameters in the fertile range for density and in the intermediate range for motility. However, men with testicular cancer statistically have lower semen quality compared to those with other malignancies. These findings further highlight the importance of pretreatment fertility preservation in this patient population before undergoing gonadotoxic treatments.