NIAGARA-ON-THE-LAKE, Ontario, Canada--While the collection of sperm
from adult males prior to cancer treatment is a routine matter, the
same issue has not yet been regularly introduced into adolescent clinics.
"We should be prepared to offer sperm banking to patients who
are about to receive chemotherapy or radiotherapy that might damage
spermatogenesis," said Jørn Müller, MD, Department
of Growth and Reproduction, The Juliane Marie Centre, Copenhagen, Denmark.
He noted that this has not commonly been an option for young men,
"and yet the technology is available to preserve their sperm and
also to use very few sperm to fertilize an egg," he said at the
5th International Conference for Long-Term Complications of Treatment
of Children and Adolescents for Cancer, hosted by Roswell Park Cancer Institute.
The Danish group has examined this topic for 3 years in adolescent
males. Several concerns have been addressed in the study, including
the often short time between the cancer diagnosis and required
therapy, the difficulty in addressing the topic with a young adult
male and his parents, the large variation in physical maturation in
adolescent males, and the limited experience in semen analysis and
cryopreservation in adolescent males.
The researchers approached 33 families. Of these, 15 boys were able
to produce semen samples for cryopreservation (via masturbation,
penile vibratory stimulation, or electroejaculation).
The age range was 13 to 18 years, with a mean of 16. Each patient had
a new diagnosis of cancer or relapsed disease. The group included
seven patients with acute lymphoblastic leukemia, three with
Hodgkins lymphoma, one with non-Hodgkins lymphoma, two
with osteosar-coma, one with a central nervous system tumor, and one
with Wilms tumor.
Semen samples from two of the boys (13 and 17 years old) did not
contain spermatozoa and were not preserved. The remaining 24 samples
were analyzed for volume and viable sperm.
60 Million Sperm per Sample
The median volume of semen delivered was 3.0 mL (range, 0.7 to 8.3
mL), and the median volume of sperm cryopreserved was 2.5 mL (range,
0.6 to 7.2 mL). The median number of spermatozoa in the samples was
60 million (range, 1.6 to 210 million). In comparison, a normal,
fertile man would produce about 250 million spermatozoa in a similar sample.
"In the lowest age range, there was a lower number of
spermatozoa as well as decreased semen volume," Dr. Müller noted.
He said that studies have shown that adolescents, even those as young
as 11, may also have semen in their urine, and although these sperm
are passively transmitted, this could offer another way to bank sperm
for the future.
"This study shows that cryopreservation of semen in young adults
is possible and suggests that the analysis of spermatogenesis in
males over the age of 10 should be considered before cancer
treatment. It offers these young men the possibility that they can
preserve their ability to father children," Dr. Müller concluded.