PENILE VIBRATORY STIMULATION AND ELECTROEJACULATION BEFORE ANTICANCERTHERAPY IN 2 PUBERTAL BOYS

Purpose: Because more than 70% of children with cancer become long-ter m survivors, more emphasis is put on reducing late effects. Cryopreser vation of semen and the intracytoplasmic sperm injection technique mak es it possible to obtain pregnancy with very poor sperm quality. Two n ew semen retrieval methods are described that are applicable in pubert al boys with a fertility potential, although not psychologically ready to produce a semen sample, who are likely to become infertile because of anticancer therapy. Patients and Methods: Two pubertal boys (aged 14 and 15 years) had a late testicular relapse of pre-B acute lymphobl astic leukemia and Hodgkin disease, stage II, respectively. In patient 1, penile vibratory stimulation (PVS) was tried under general anesthe sia without success and electroejaculation (EEJ) was performed. Before alkylating chemotherapy and testicular irradiation, PVS was performed with success in patient 2. Results: An antegrade ejaculate of 0.7 mi with 1% motile spermatozoa and an retrograde ejaculate with 1.6 x 10(6 )/ml spermatozoa (5% with fair motility) was obtained from patient I. An antegrade ejaculate of 1.5 mi with 2.5 x 10(6)/ml spermatozoa (29% with fair motility) was obtained from patient 2. Conclusions: PVS shou ld be the first choice of treatment because it is noninvasive, simple, and easily applied. Because EET requires general anesthesia, it shoul d be used as a second option.