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      Long-Term Experience of Sperm Cryopreservation in Cancer Patients in a Single Fertility Center

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          Abstract

          Purpose

          Sperm cryopreservation before cancer treatment is the most effective method to preserve the fertility of male patients. We present our 21 years experience with sperm cryopreservation for cancer patients, including an examination of semen quality, the current status of cryopreserved sperm, and the rate of sperm use for assisted reproductive technology (ART).

          Materials and Methods

          A total of 721 cancer patients at Fertility Center of CHA Gangnam Medical Center successfully performed sperm cryopreservation for fertility preservation from January 1996 to December 2016. Medical chart review was used to analyze patient age, marital status, cancer type, semen volume, sperm counts and motility, length of storage, and current banking status.

          Results

          The major cancers of the 721 patients were leukemia (28.4%), lymphoma (18.3%), testis cancer (10.0%). The mean age at cryopreservation was 27.0 years, and 111 patients (15.4%) performed sperm cryopreservation during or after cancer treatment. The mean sperm concentration was 66.7±66.3 ×10 6/mL and the mean sperm motility was 33.8%±16.3%. During median follow-up duration of 75 months (range, 1–226 months), 44 patients (6.1%) used their banked sperm at our fertility center for ART and 9 patients (1.2%) transferred their banked sperm to another center. The median duration from cryopreservation to use was 51 months (range, 1–158 months).

          Conclusions

          Sperm cryopreservation before gonadotoxic treatment is the most reliable method to preserve the fertility of male cancer patients. Sperm cryopreservation should be offered as a standard of care for all men planning cancer therapy.

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          Most cited references16

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          Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2014

          Purpose This study presents the 2014 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality. Materials and Methods Cancer incidence data from 1999 to 2014 was obtained from the Korea National Cancer Incidence Database and followed until December 31, 2015. Mortality data from 1983 to 2014 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2015, among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality, prevalence, and 5-year relative survivals were also calculated. Results In 2014, 217,057 and 76,611 Koreans were newly diagnosed and died from cancer respectively. The ASRs for cancer incidence and mortality in 2014 were 270.7 and 85.1 per 100,000, respectively. The all-cancer incidence rate has increased significantly by 3.4% annually from 1999 to 2012, and started to decrease after 2012 (2012-2014; annual percent change, –6.6%). However, overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2010 and 2014 was 70.3%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995. Conclusion Age-standardized cancer incidence rates have decreased since 2012 and mortality rates have also declined since 2002, while 5-year survival rates have improved remarkably from 1993-1995 to 2010-2014 in Korea.
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            Fertility preservation and reproduction in cancer patients.

            (2005)
            Cancer treatment often results in reduced fertility. Cancer patients should be informed of options for fertility preservation and future reproduction prior to cancer treatment. Reproduction in the context of cancer raises a number of ethical issues related to both patient and offspring welfare.
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              Sperm cryopreservation before cancer chemotherapy helps in the emotional battle against cancer.

              Sperm cryopreservation before cancer chemotherapy is available for young patients with cancer. However, few patients bank their sperm. The authors evaluated by questionnaire the psychological impact of sperm cryopreservation. The authors cryopreserved the sperm of 111 patients with cancer for free at the Yokohama City University (Yokohama, Japan). For the current study, questionnaires were mailed to 66 patients whose sperm had been cryopreserved. Fifty-one patients (77.3%) with testicular carcinomas (n = 24), leukemia or malignant lymphoma (n = 19), or other cancers (n = 8) answered the questionnaire. The average age at collection and the period of sperm cryopreservation were 30.1 +/- 6.0 (mean +/- standard deviation) and 3.3 +/- 2.2 years, respectively. Many patients were informed of the deleterious effects of cancer chemotherapy and worried about infertility in the future. However, only half of the patients banked their sperm on their own initiative. Other patients followed their physician's instruction. Eighty percent of patients replied that sperm cryopreservation helped in the battle against cancer. Sperm banking especially was found to encourage every patient who banked sperm on their own initiative. After cancer chemotherapy, 70% of patients wanted to have a child. However, 60% of patients were worried about infertility in spite of having their sperm cryopreserved. No patients wanted to use cryopreserved sperm for fathering children if their spermatogenesis was restored. Sperm cryopreservation invigorated many patients with cancer after cancer treatments. The majority of patients recommended sperm cryopreservation to other cancer patients. Sperm cryopreservation encouraged young patients with cancer during and after cancer treatment. It should be recommended for all young patients with cancer. However, sperm cryopreservation did not eliminate their fear of infertility. (c) 2005 American Cancer Society.
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                Author and article information

                Journal
                World J Mens Health
                World J Mens Health
                WJMH
                The World Journal of Men's Health
                Korean Society for Sexual Medicine and Andrology
                2287-4208
                2287-4690
                May 2019
                26 December 2018
                : 37
                : 2
                : 219-225
                Affiliations
                [1 ]Department of Urology, Fertility Center of CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea.
                [2 ]Department of Urology, CHA Fertility Center, Seoul Station, CHA University College of Medicine, Seoul, Korea.
                [3 ]Fertility Center of CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea.
                [4 ]Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea.
                Author notes
                Correspondence to: Dong Suk Kim. Department of Urology, Fertility Center of CHA Gangnam Medical Center, 566 Nonhyeon-ro, Gangnam-gu, Seoul 06135, Korea. Tel: +82-2-3468-3413, Fax: +82-2-3468-3449, dngskkim100@ 123456gmail.com
                Author information
                https://orcid.org/0000-0003-4649-9129
                https://orcid.org/0000-0003-3237-6304
                https://orcid.org/0000-0002-4581-3182
                https://orcid.org/0000-0003-3678-2801
                https://orcid.org/0000-0001-5405-0909
                https://orcid.org/0000-0002-3364-2427
                https://orcid.org/0000-0002-9096-9370
                https://orcid.org/0000-0001-5572-0898
                https://orcid.org/0000-0001-7350-0303
                Article
                10.5534/wjmh.180061
                6479079
                30588786
                74453fd5-9dbb-4ce2-b657-65dedb318fd7
                Copyright © 2019 Korean Society for Sexual Medicine and Andrology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 July 2018
                : 19 November 2018
                : 05 December 2018
                Funding
                Funded by: National Research Foundation of Korea, CrossRef https://doi.org/10.13039/501100003725;
                Award ID: 2018R1C1B5083794
                Categories
                Original Article

                cryopreservation,fertility,neoplasms,semen preservation
                cryopreservation, fertility, neoplasms, semen preservation

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