Objectives. Current techniques in cryopreservation of human semen subs
tantially decrease sperm quality. In addition, the pregnancy rate usin
g cryopreserved sperm obtained from testicular cancer patients is lowe
r than when sperm from normal fertile men is used. However, it is stil
l unclear whether cryopreserved sperm from these patients is inherentl
y defective or if the sperm loses its motility after thawing. This stu
dy was undertaken to assess the effect of cryopreservation on the qual
ity and motion characteristics of semen from patients with testicular
cancer before definitive therapy compared with semen from normal volun
teers. Methods. We compared the sperm quality before and after cryopre
servation in samples from 34 patients with testicular cancer and 30 no
rmal volunteers who were referred for sperm banking over a 7-year peri
od. The effects of cancer stage and histologic type on various semen p
arameters were also examined. A computer-assisted semen analysis was p
erformed before and after cryopreservation on each specimen. The nitro
gen vapor technique using Test yolk buffer with glycerol as a cryoprot
ective agent was used for cryopreservation. The motile sperm count and
motion characteristics (motility, velocity, linearity, amplitude of t
he lateral head movement, motility index) were analyzed before and aft
er cryopreservation and compared between the groups. Results. Semen qu
ality did not significantly differ among patients with Stage I, II, or
III cancer. However, semen duality tended to be poorer at higher canc
er stages. In general, semen duality was better among patients with pu
re seminomas than with pure embryonal tumors; quality was worst among
patients with mixed germ cell tumors. However, 71.4% of patients with
mixed tumors presented with Stage III disease, whereas all patients wi
th seminomas presented with Stage I disease. Significant differences w
ere also seen in prefreeze motility (median, 42% [interquartile range,
24 to 51] versus 60.5% [range, 49 to 73]; P = 0.0004) and motile sper
m count (6.7 x 10(6)/ml [range, 3.4 to 14.4] versus 50.0 [range, 24.6
to 72.0]; P = 0.0001) in patients compared with controls, respectively
. The motile sperm count and percent motility significantly decreased
in both patients and controls after cryopreservation (P = 0.0001). How
ever, the percentage decline in motile sperm count and motion characte
ristics after cryopreservation did not differ significantly between pa
tients and controls (P > 0.01). Conclusions. We conclude that the effe
ct of cryopreservation on sperm quality in patients with testicular ca
ncer is identical to its effect on sperm from normal fertile men. Diff
erences in values after preservation are explained by poor semen chara
cteristics before freezing; semen duality declines with more extensive
disease. Stage I patients also had poorer quality than control subjec
ts. Thus, we recommend that routine sperm banking be encouraged among
all patients with testicular cancer before the initiation of specific
medical treatment. We also recommend that future efforts be focused on
improving the technique of sperm banking.