Papler, T. B., Vrtacnik-Bokal, E., Drobnic, S., & Stimpfel, M. (2021). The outcome of IVF/ICSI cycles in male cancer patients: retrospective analysis of procedures from 2004 to 2018. Radiology and oncology. https://doi.org/10.2478/raon-2021-0011
Papler TB, Vrtacnik-Bokal E, Drobnic S, Stimpfel M. The outcome of IVF/ICSI cycles in male cancer patients: retrospective analysis of procedures from 2004 to 2018. Radiology and oncology. 2021. doi:10.2478/raon-2021-0011
Papler, Tanja Burnik, et al. "The outcome of IVF/ICSI cycles in male cancer patients: retrospective analysis of procedures from 2004 to 2018." Radiology and oncology, 2021.
For EndNote, Zotero or Mendeley:
Open access
No open license is recorded for this paper. Reuse terms are set by the publisher.
Open Access
Free full text on PubMed Central (PMC8042825)
RRM Academy Synopsis
Fresh and frozen sperm gave similar IVF/ICSI live births after cancer
In 214 IVF/ICSI cycles for men treated for cancer at one Slovenian center, fresh and frozen sperm gave similar live-birth rates per egg retrieval. Across all cycles, about 6 out of 10 couples using frozen sperm had a pregnancy, against about 4 out of 10 using fresh sperm. Live births per couple did not differ significantly.
Key Findings
The retrospective analysis covered 214 IVF/ICSI cycles in 115 couples at one IVF center in Ljubljana from 2004 to 2018. Of these, 130 cycles used cryopreserved semen and 84 used fresh semen.
In fresh cycles, per oocyte aspiration, pregnancy was 30.0% with cryopreserved semen and 21.4% with fresh semen (p = 0.12); live births were 22.3% and 17.9% (p = 0.43).
Embryo utilization was 48.9% with cryopreserved semen and 40.0% with fresh semen (p = 0.006). Embryo cryopreservation rates were 17.3% and 12.7% (p = 0.048).
At least one pregnancy per couple, with fresh and frozen-thawed cycles together, occurred in 60.6% of couples with cryopreserved semen and 37.7% with fresh semen (p = 0.012).
At least one live birth per couple occurred in 45.1% of couples with cryopreserved semen and 34.0% with fresh semen, a difference that was not significant (p = 0.21).
Interpretation
The study is a retrospective analysis from one center. The clinic chose fresh or frozen semen for each patient individually, and used frozen semen for all azoospermic and aspermic men (those with no sperm or no semen to collect). Clinical decisions therefore formed the two groups. The groups also differed in the causes of female infertility, and ICSI was used more often with frozen semen. The authors note that protocols and embryo culture conditions changed over the 15 years and applied to both groups.
RRM Context
Male factor contributes to many couples' infertility. The authors note that cancer and its treatment can cause it. They cite an estimate that approximately 15–30% of male cancer survivors become infertile afterward. IVF/ICSI works around the male factor and leaves the cause in place. Restorative reproductive medicine evaluates both partners and looks for the cause in each.
Our editorial summary of this paper, not the article's abstract.
Abstract
Fertility preservation is an important aspect of quality of life in oncological patients, and in men is achieved by semen cryopreservation prior to treatment. Results of in vitro fertilization (IVF) procedures in healthy infertile couples are comparable, regardless of whether fresh or cryopreserved semen is used, but are scarce in male oncological patients. We performed a retrospective analysis of IVF/intracytoplasmic sperm injection (IVF/ICSI) procedures in infertile couples where men had been treated for cancer in the past. We additionally compared the results of IVF/ICSI procedures with respect to the type of semen used (fresh, cryopreserved). We compared the success rates of 214 IVF/ICSI cycles performed in the years 2004-2018. Pregnancy (30.0% vs. 21.4%; p = 0.12) and live-birth rates (22.3% vs. 17.9%; p = 0.43) per oocyte aspiration were similar between the groups in fresh cycles; however embryo utilization (48.9% vs. 40.0%; p = 0.006) and embryo cryopreservation rates (17.3% vs. 12.7%; p = 0.048) were significantly higher in the cryopreserved semen group. The cumulative pregnancy rate (60.6% vs. 37.7%; p = 0.012) was significantly higher, and the live-birth rate (45.1% vs. 34.0%; p = 0.21) non-significantly higher, in the cryopreserved semen group. The success of IVF/ICSI procedures in couples where the male partner was treated for cancer in the past are the same in terms of pregnancies and live-births in fresh cycles regardless of the type of semen used. However, embryo utilization and embryo cryopreservation rates are significantly higher when cryopreserved semen is used, leading to a significantly higher cumulative number of couples who achieved at least one pregnancy.
