Sperm cryopreservation in adolescents and young adults with cancer: results of the French national sperm banking network (CECOS)

Abstract

Objective: To determine the feasibility of fertility preservation in adolescent males with cancer.

Design: Large multicenter retrospective study of male patients ≤20 years from 23 centers of a national network of sperm banks over a 34-year period.

Setting: Sperm banks.

Patient(s): A total of 4,345 boys and young men aged 11 to 20 years.

Intervention(s): Age, cancer diagnosis, feasibility of sperm banking, and sperm parameters.

Main outcome measure(s): Description of patients, and success of their fertility preservation.

Result(s): We observed a mean yearly increase in referred patients of 9.5% (95% confidence interval, 9.1%-9.8%) between 1973 and 2007. Over the study period, the percentage of younger cancer patients who banked their sperm increased, especially in the 11-14 year age group, rising from 1% in 1986 to 9% in 2006. We found that 4,314 patients attempted to produce a semen sample, 4,004 succeeded, and sperm was banked for 3,616. The mean total sperm count was 61.75 × 10(6) for the 11-14 year age group, and 138.81 × 10(6) for the 18-20 year age group. It was noteworthy that intercenter variations in practices involving young patients seeking to preserve their fertility before cancer therapy were observed within this national network.

Conclusion(s): Our results emphasize the need for decisive changes in public health policy to facilitate the access to reproductive health-care for young cancer patients.

Keywords: Adolescents; age; cancer; fertility preservation; sperm cryopreservation.