Scientists from Weill Cornell Medical Center have come up with a new fertility option for male cancer survivors thought to be sterile due to earlier cancer treatments. In the study, published online March 15, 2011, in the Journal of Clinical Oncology, researchers showed that a surgical technique called TESE (microdissection testicular sperm extraction) effectively located and extracted viable sperm in more than one-third of a group of 73 adult male childhood cancer survivors, all of whom had been considered infertile due to chemotherapy treatment. After the surgery, more than half the men went on to father children via in-vitro fertilization (IVF). The fertility rate in the group was slightly more than 57, with a successful pregnancy rate of 50 percent.
"It was previously assumed that most male survivors of childhood cancer whose semen contained little to no viable sperm were incapable of fathering children. This study demonstrates that some of these men do in fact still produce healthy sperm, and that this technique can help men experience parenthood," says senior author Dr. Peter Schlegel, chairman of the Department of Urology at Weill Cornell Medical College and urologist-in-chief at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York.
Most adult men who received certain types of chemotherapy in childhood or adolescence have traditionally been considered infertile, leading even the authors of the study to be pleasantly surprised by their results.
"When we started this study, we thought sperm retrieval rates would be close to zero among the group of cancer survivors, but we were surprised to discover that in many cases small areas of testicular tissue survived and resumed sperm production over a period of several years," Dr. Schlegel says. "Even in this situation where we thought sperm production had ceased, there still may be an opportunity for fertility with the use of assisted reproductive techniques like this one."
Dr. Schlegel notes that freezing and preserving sperm prior to chemotherapy for later use is an important and frequently possible option for males diagnosed with cancer. However, “sperm banking" remains underused for a number of reasons, including poor sperm quality, young age, cost, and a desire to promptly start chemotherapy treatment. Study authors recommend that doctors offer the option to adolescents and men before starting chemotherapy.