Fertility after cancer: a prospective review of assisted reproductive outcome with banked semen specimens

Objective: To examine the outcome of assisted reproduction techniques (ART) using cryopreserved semen from patients with cancer. Design: Prospective. Setting: Therapeutic semen banking program at a tertiary healthcare center. Patient(s): Twenty-nine men with cancer who cryopreserved their sperm before treatment at our facility from 1982 to 2001 and withdrew their samples for assisted reproduction (IUI, IVF, or intracytoplasmic sperm injection [ICSI]). Intervention(s): Sperm bank records were used to identify the patients. Information on fertility potential indices was obtained from medical records and through interviews. Of the 29 patients, 9 had testicular cancer, 12 had Hodgkin's disease, and 8 had other types of cancer. Main Outcome Measure(s): Pregnancy and live births. Result(s): A total of 87 ART cycles (42 IUI, 26 IVF, and 19 ICSI) was performed. Of those cycles, 18.3% resulted in pregnancy (7% IUI, 23% IVF, and 37% ICSI), and 75% of the pregnancies resulted in a live birth (100% IUI, 83% IVF, and 57% ICSI). There was no significant difference in the outcomes when the results were stratified by type of ART and malignancy. None of the 11 infants who were born had congenital anomalies. Conclusion(s): Our findings emphasize the need for physicians to discuss the issue of semen cryopreservation with all men of reproductive age who have cancer before antineoplastic therapy is started. (C)2004 by American Society for Reproductive Medicine.