Raw and test-thaw semen parameters after cryopreservation among men with newly diagnosed cancer.

OBJECTIVE: To characterize sperm parameters from thawed semen samples of men with different cancers who cryopreserved semen before oncologic therapy. DESIGN: Retrospective cohort study. SETTING: Tertiary academic medical center. PATIENT(S): 1,010 semen samples collected between 1994 to 2010. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Mean total motile count (TMC), change in percentage motility and percentage survival (100 * [postthaw % motility/raw % motility]) for each cancer compared with data from samples of men without cancer (the "procreative management" group), and proportion of postthaw samples with TMC >5 × 10(6). RESULT(S): The procreative management group had the best raw and postthaw semen quality. The best raw and postthaw semen quality for cancer patients occurred in those with prostate cancer (TMC of 155.1 and 53.2 × 10(6), respectively) and the worst in those with leukemias. Lymphoid leukemias demonstrated the worst raw TMC (26.8 × 10(6)), but myeloid leukemias displayed the worst postthaw TMC (6.9 × 10(6)). The testicular cancer group was the only group with a statistically significantly lower chance of having TMC >5 × 10(6). CONCLUSION(S): Men with testicular cancer were most commonly referred for sperm cryopreservation and were the only group that was statistically significantly less likely to have TMC >5 × 10(6) on postthaw semen analysis. The most severe reduction in TMC was seen in the myeloid leukemia group, suggesting that these patients along with men with testis cancer and those with lymphoid leukemia should be counseled to provide increased numbers of specimens for fertility preservation.

Recovery, isolation, identification, and preparation of spermatozoa from human testis.

In some cases, human spermatozoa to be used for in vitro fertilization are processed from testicular or epididymal biopsies collected in the clinic or operating room. An appropriately equipped Andrology or Embryology Laboratory is required. Sterility must be maintained at all stages from collection and transport to identification and processing to insemination or cryopreservation. The technologist must be able to properly process and identify spermatozoa from aspirates, seminiferous tubules or pieces of testicular tissue. Recovery of undamaged spermatozoa from tubules or tissue requires mincing, squeezing, or vortexing the tissue, usually without the need of enzymatic digestion. A motility stimulant such as Pentoxifylline is commonly used to calculate the number of functionally competent spermatozoa. After recovery, spermatozoa may be used immediately for IVF-ICSI, incubated overnight prior to IVF-ICSI, or cryopreserved for future use. Methods for identifying, purifying, and determining the number and motility of spermatozoa during these processes are presented.