What are current practices of post-treatment fertility preservation in male childhood cancer survivors (CCS) who have not benefitted from pre-therapeutic fertility preservation in France and other European countries?
A survey was conducted of all fertility preservation centres in France (n = 30) and European fertility specialists (n = 9) in five European countries. Eight clinical cases and 40 questions were included to assess the effect of age at diagnosis, type of treatment (alkylating-agents, orchidectomy, testicular radiotherapy) and sperm parameters on the probability of a post-treatment fertility preservation proposal. Demographic characteristics of the responding practitioner were also collected.
Post-treatment sperm cryopreservation was proposed by 100% of fertility specialists in cases of severe oligoasthenoteratozoospermia, 77-88% in cases of moderate oligoasthenoteratozoospermia and in 65-77% in cases of sperm motility and vitality impairment. In cases of normal sperm parameters, 27-54% of fertility specialists would propose post-treatment sperm cryopreservation. These results did not differ significantly according to the type of treatment received or to responder-related factors. Practices of European specialists were also guided by sperm parameter results; 44-67% of specialists responding that they would propose sperm cryopreservation in cases of moderate to severe sperm parameter alterations.
Post-treatment semen analysis could be widely proposed to CCS who have not benefitted from pre-therapeutic fertility preservation. Post-treatment fertility preservation could be proposed in cases of persistent moderate to severe sperm parameter alterations. Guidelines would be important to homogenize practices and to encourage oncologists to refer CCS for fertility assessments.
Reproductive biomedicine online. 2023 Oct 02 [Epub ahead of print]
Gayané Sarian, Céline Chalas, Gwénaël Le Teuff, Chiraz Fayech, Agnès Dumas, Charlotte Demoor-Goldschmidt, Brice Fresneau
University of Paris-Cite, Paris, France., Hospital Cochin, University of Paris-Cite, Department of Reproductive Biology-CECOS, Paris, France; Fédération française des CECOS, Toulouse, France., Gustave Roussy, Paris-Saclay University, Department of Biostatistics and Epidemiology, Villejuif, F-94805, France., Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France., University of Paris-Cite, ECEVE UMR 1123, F-75010 Paris, France; Inserm, Center for Research in Epidemiology and Public Health, U 1018, Epidemiology of Radiation, Villejuif, France., Inserm, Center for Research in Epidemiology and Public Health, U 1018, Epidemiology of Radiation, Villejuif, France; University Hospital of Angers, Department of Pediatric Oncology and Hematology, Angers, France; Centre François Baclesse, Department of Radiotherapy and Protontherapy, Caen, France; Centre François Baclesse, Department of Supportive Care, Caen, France., Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France; Inserm, Center for Research in Epidemiology and Public Health, U 1018, Epidemiology of Radiation, Villejuif, France. Electronic address: .