Spontaneous miscarriage after intracytoplasmic sperm injection with frozen sperm of patients with testicular germ cell tumour

Haru Hamada; Akifumi Ijuin; Tomonari Hayama; Naoki Tsuchiya; Sumiko Sueyoshi; Misaki Toda; Ai Miyakoshi; Mayuko Kurumizaka; Marina Saito; Yuki Oike; Hiroe Ueno; Shinnosuke Kuroda; Kazumi Takeshima; Teppei Takeshima; Shin Saito; Ryoko Asano; Taichi Mizushima; Yasushi Yumura; Hideya Sakakibara; Etsuko Miyagi; Miki Tanoshima; Mariko Murase

doi:10.1111/bju.70332

Spontaneous miscarriage after intracytoplasmic sperm injection with frozen sperm of patients with testicular germ cell tumour

BJU Int. 2026 Jun 3. doi: 10.1111/bju.70332. Online ahead of print.

Authors

Haru Hamada¹, Akifumi Ijuin^{1

2}, Tomonari Hayama^{1

3}, Naoki Tsuchiya^{1

4}, Sumiko Sueyoshi^{1

4}, Misaki Toda¹, Ai Miyakoshi¹, Mayuko Kurumizaka¹, Marina Saito¹, Yuki Oike¹, Hiroe Ueno¹, Shinnosuke Kuroda¹, Kazumi Takeshima¹, Teppei Takeshima¹, Shin Saito³, Ryoko Asano³, Taichi Mizushima⁴, Yasushi Yumura¹, Hideya Sakakibara³, Etsuko Miyagi⁴, Miki Tanoshima⁵, Mariko Murase¹

Affiliations

¹ Center for Reproductive Medicine, Yokohama City University Medical Center, Yokohama, Japan.
² Clinical Research Department, Yokohama City University Medical Center, Yokohama, Japan.
³ Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan.
⁴ Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama, Japan.
⁵ Department of Clinical Genetics, Yokohama City University Medical Center, Yokohama, Japan.

PMID: 42233170
DOI: 10.1111/bju.70332

Abstract

Objective: To clarify the impact of chromosomal aberrations on the offspring of patients with testicular germ cell tumour (TGCT) by evaluating the outcomes of intracytoplasmic sperm injection (ICSI).

Patients and methods: Under the ethical review of Yokohama City University, 12 patients with TGCT and 25 with non-TGCT cancer who had cryopreserved sperm for ICSI for fertility preservation between 1 April 2014 and 31 March 2023 were enrolled. For 198 oocytes from the TGCT group, 480 oocytes from the non-TGCT group, fertilisation, embryo viability, pregnancy, and spontaneous miscarriage rates were examined.

Results: Females who received ICSI from patients with TGCT showed a significantly higher spontaneous miscarriage rate than those who received ICSI from patients with non-TGCT cancer (43.8% vs 9.1%, respectively, P < 0.05), with no significant between-group difference in the pregnancy rate. In the TGCT group, three cases of recurrent pregnancy loss and recurrent implantation failure were reported. The high spontaneous miscarriage rate in the TGCT group can be attributed to chromosomal abnormalities or DNA fragmentation in the sperm of patients with TGCT.

Conclusion: Natural conception may be an option for patients who have completed TGCT treatment and have adequate sperm. However, when semen parameters do not recover sufficiently, assisted reproductive technologies may be considered, including, where possible, the use of post-treatment sperm not affected by TGCT rather than pre-treatment sperm collected during tumour-bearing state. In selected cases, pre-implantation genetic testing for aneuploidy may also be considered.

Keywords: cryopreservation; fertility preservation; intracytoplasmic sperm injection; sperm aneuploidy; spontaneous miscarriages; testicular germ cell tumour.