演題抄録

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開催概要
開催回
第58回・2020年・京都
 

がん経験者の男性不妊患者でがん治療は精子採取手術の可否に影響しないかもしれない

演題番号 : P-389

[筆頭演者]
日比 初紀:1 
[共同演者]
松浦 彩乃:2、酒井 智絵:2、浅田 義正:3

1:協立総合病院・泌尿器科、2:協立総合病院・看護部、3:浅田レディースクリニック・産婦人科

 

Introduction
Nowadays timely sperm cryopreservation which can be used for future assisted reproductive technology (ART) for men with cancer is the best modality to ensure male fertility. In approximately 12% of men, no viable spermatozoa are present for cryopreservation before the start of cancer treatment. We retrospectively investigated whether cancer treatment affected male infertility treatment for cancer survivors who consulted our male infertility division.
Materials and methods
1,532 male infertility patients who consulted our division between 2010 and 2019, and 57 (3.72%) subjects had a past history of cancer treatment. Of these, 25 subjects received surgical sperm retrieval due to azoospermia or ejaculatory dysfunction.
Results
The type of cancer included testicular cancer (9 cases), hematologic (6), colorectal (3), osteosarcoma (2), kidney (2), extragonadal (2), gallbladder (1), and rhabdomyosarcoma (1). One subject had history of kidney and gallbladder cancer. Sperm retrieval surgery was performed by using vasal sperm aspiration (ReVSA) in 4 cases, epididymal sperm aspiration (MESA) in 2, microscopic testicular sperm extraction (micro-TESE) in 18, and onco-TESE in 1. Motile sperm recovery achieved in 14/25 (56.0%) cases. Sperm retrieval rates were 38.9% (7/18 subjects) by micro-TESE, and 100% by ReVSA (4/4), MESA (2/2), onco-TESE (1/1), respectively. Although the relationship of cancer type and successful sperm retrieval was unclear, 8 pregnancies and 7 healthy deliveries (28.0%) were achieved with intracytoplasmic sperm injection (ICSI).
Conclusions
Successful sperm retrieval was achieved in 56.0% cancer survivors and 28.0% could become a biological fatherhood. This might greatly agree an opportunity for cancer survivors to achieve fertility, including those who had received intensive cancer treatments. In this series, cancer treatment for cancer survivors may not affect successful sperm retrieval and ICSI outcome.

キーワード

臓器別:前立腺・男性生殖器

手法別:がん生殖医療

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