Cryopreservation of sperm from patients with leukemia - Is it worth the effort?

BACKGROUND. Intracytoplasmic sperm injection (ICSI) allows pregnancies to b e established with a single sperm, improving the chances for men with sever ely impaired sperm quality to cause a pregnancy. Men with leukemia typicall y are of reproductive age and their fertility is threatened by initially im paired semen quality and cytotoxic chemotherapy. The authors examined the f easibility of sperm cryopreservation in men with leukemia before treatment and whether the type of leukemia is related to prefreeze or postthaw semen quality. METHODS. Records of 25 patients with acute (n = 13) or chronic (n = 12) leu kemia who banked their sperm were reviewed. Semen characteristics were comp ared with those of normal donors (n = 50) and between the 2 patient groups before and after cryopreservation. Motile sperm count (MSC), motility, curv ilinear velocity (VCL), linearity, and amplitude of lateral head movement w ere compared between patients and healthy donors. No patient had undergone chemotherapy before sperm banking. The nitrogen vapor technique was used fo r sperm cryopreservation. RESULTS, Patients with leukemia had significantly lower prefreeze and postt haw MSC (P = 0.0001), motility (P < 0.05), and VCL (P < 0.05) compared with healthy donors. The percentage change from prefreeze to postthaw in MSC an d motility (P < 0.05) was significantly greater in patients than in healthy donors. The effect of cryopreservation on semen quality was similar in pat ients with both acute and chronic leukemia. CONCLUSIONS. Patients with leukemia have poor prefreeze and postthaw semen quality compared with healthy donors. In this study the type of leukemia di d not appear to affect prefreeze or postthaw semen quality and the postthaw MSC was sufficient for use with ICSI. Sperm cryopreservation should be off ered to all men of reproductive age before the initiation of therapy for le ukemia. (C) 1999 American Cancer Society.