Outcomes of operative sperm retrieval strategies for fertility preservation among males scheduled to undergo cancer treatment.

Overview

OBJECTIVE: To describe the outcomes of electroejaculation (EEJ) and testicular sperm extraction (TESE) performed for fertility preservation among male patients who are unable to ejaculate or have nonobstructive azoospermia/severe oligospermia before definitive cancer therapy. DESIGN: Retrospective cohort study. SETTING: Tertiary cancer referral center. PATIENT(S): Forty-nine patients seeking fertility preservation before definitive cancer therapy, with anejaculation, religious or cultural objections to masturbation, azoospermia, or severe oligospermia requiring either EEJ or TESE. INTERVENTION(S): EEJ and TESE. MAIN OUTCOME MEASURE(S): Sperm retrieval rates. RESULT(S): Fifty-nine percent of patients overall and 60% of adolescents/young adults had sperm retrieved for cryopreservation. EEJ was successful in retrieving sperm in 60% of adolescents. Of all adolescents and young adults undergoing TESE, 33% had sperm retrieved for cryopreservation. No complications were reported. Chemotherapy was commenced without delay in all patients requiring it, frequently on the same day as the sperm retrieval. CONCLUSION(S): EEJ and TESE can be safely and successfully used for fertility preservation before cancer therapy among boys and young adult men who are unable to provide a semen specimen or have nonobstructive azoospermia, and they should be considered in all men meeting this patient profile.