Aldurayhim, Abbas (2020) Semen quality and semen cryopreservation in patients with testicular cancer at a tertiary academic center in the Netherlands. thesis, Medicine.
Full text available on request.Abstract
Introduction: the aims of our study were to investigate the effect of different types and stages of testicular cancer (TC) and the short- and long-term effects of its treatment (chemotherapy (CH) and radiotherapy (RT)) on spermatogenesis. We also evaluated the usage of cryopreserved semen (SCP) in preserving fertility of TC patients. Methods: To study the effect of TC and the usage of SCP, we evaluated retrospectively 516 TC patients (non-seminoma (NS): 357 (69%), seminoma (S): 159 (31%)), who were referred for semen cryopreservation to our fertility center before starting with CH or RT in the past 28 years. To evaluate the effects of CH and RT, we study here only 180 patients out of 516, who had at least one follow up post-treatment, CH patients; n = 154 and RT patients; n = 26. Results: In comparison to S patients, NS patients had lower total motile sperm count (P=0.04) in non-metastatic stage, while in metastatic stages, S patients had a lower total motile sperm count and lower progressive motility (P=0.03 and P=0.01, respectively). Almost half of the patients in both types and stages had lower sperm concentration per ml than normal according to the WHO. Comparing the different stages of S and the different stages of NS separately shows that there is no significant difference between the stages in semen parameters. In CH patients, there was a significant decrease in all semen parameters in the first two years after treatment (volume (P=0.008), sperm concentration (P>0.001), progressive motility (P=0.007) and total motile sperm count (P>0.001). In year three onwards, semen parameter has returned to the baseline level. For the RT patients, except for the volume, there was no significant differences in the other semen parameter between the baseline and follow-ups. Four patients became azoospermic after CH and one patient after RT. 36 (7%) of the patients return to use their cryopreserved sperm for fertility treatment, 39 pregnancies were achieved and the live birth number was 36. Conclusion: Our study highlights that both subtypes of TC promote deleterious effects on semen quality. However, in non-metastatic stage, NS patients have a worse semen quality than patients with S, while in metastatic stages, S patients have a worse semen quality. The use of SCP resulted in a considerable successful rate of achieving fatherhood. Due to the risk of becoming azoospermic, all TC patients should be inform about SCP prior to treatment.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Meijer, B. |
| Faculty: | Medical Sciences |
| Date Deposited: | 26 Jul 2023 11:09 |
| Last Modified: | 26 Jul 2023 11:09 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3600 |
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