For men with Hodgkin lymphoma who want to become fathers after cancer treatment, freezing and storing semen samples before treatment greatly increases the chances they will be able to, according to a study published online ahead of print in the journal Human Reproduction (doi: 10.1093/humrep/det430).
The findings are among the first to quantify the proportion of cancer patients who freeze semen before treatment—apart from smaller studies in single fertility centers with limited follow-up of patients—as well as being the first study to report factors influencing whether or not semen is cryopreserved, the researchers noted.
“Our study shows that cryopreservation of semen before cancer treatment has a large impact: one in five children born after Hodgkin lymphoma treatment was born using cryopreserved semen. Among survivors wishing to become a father after treatment, the availability of cryopreserved semen doubled the odds of successful fatherhood,” the study's lead author, Marleen van der Kaaij, MD, a PhD student at the University Medical Centre in Groningen in the Netherlands, said in a news release.
The study is based on a survey sent to 1,849 male survivors of Hodgkin lymphoma. Of 902 men who responded, 334 reported wanting to have children after treatment. Of those, 83 of 112 men who had not cryopreserved semen succeeded and 175 of 222 men who had cryopreserved semen succeeded. The chances of fatherhood after treatment doubled when semen cryopreservation was performed when the influence of alkylating agents, age at treatment, and second-line treatment was taken into account.
“Twenty-three percent of men unable to conceive spontaneously did not have cryopreserved semen available and could not become fathers,” she said. “Whereas, among men who did use cryopreserved semen we found a success rate of 62 percent, and several men were still in the process of fertility treatment at the time of the survey. This underlines the importance of making available information and access to cryopreservation facilities for cancer patients. Clinicians should realize the enormous impact of this cheap and simple procedure.”
The surveys also found:
- Men treated with chemotherapy were four times more likely to freeze their semen, and twice as likely if they were receiving a second-line treatment for progression or relapse, which would be more likely to be alkylating therapy;
- Better educated men were 60 percent more likely to freeze their semen, and men older than 30 were less likely to freeze semen than men younger than 30; and
- Men treated after 1994 were more than 10 times more likely to freeze semen than those treated between 1974 and 1983, and men treated between 1984 and 1993 were four times more likely than men treated before 1984.