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For Men Considered Sterile after BMT for Hematological Malignancies, New Technique Makes It Possible to Father Children

doi: 10.1097/01.COT.0000368864.60565.26
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Men who were previously deemed sterile due to aggressive cancer treatments may still be able to biologically father children, according to data reported in Bone Marrow Transplantation.

The study's lead author, Paul Turek, MD, former professor and endowed chair at the University of California San Francisco and founder of the Turek Clinic, pioneered the technique, called FNA Sperm Mapping, which makes it possible to discover pockets of viable sperm in the testes. The sperm can then be extracted with minimally invasive procedures and used for in vitro fertilization and single sperm injection.

“This has been a long time in the making, but we have reached a point where a critical mass of physicians believe in and are using sperm mapping as a state-of-the-art tool to help couples conceive,” Dr. Turek said in a news release. “Sperm mapping offers men who are ‘sterile’ new hope for fatherhood.”

The study documents two cases of men who had received high doses of chemotherapy and bone marrow transplantation. The men had previously been diagnosed and treated for chronic myelogenous leukemia and Hodgkin's disease, and later as survivors, desired to father children.

The men were initially found to have no sperm in their ejaculate, a situation that occurs in some 70% of cancer survivors after bone marrow transplantation. After undergoing the testis sperm mapping technique, small pockets of sperm were discovered, and with assisted reproduction using these sperm, both men successfully fathered healthy children.

Dr. Turek noted that although previously published research had shown a 65% success rate in finding sperm in the testis of patients with azoospermia after chemotherapy for both benign and malignant disease, the new study involved men who received the much higher doses of chemotherapy that are typically associated with bone marrow transplants. And despite the use of assisted reproduction in chemotherapy-exposed sperm, no increase in birth defect rates have been noted, he said.

He cautioned, however, that for men who need radiation and chemotherapy, sperm banking prior to the therapy remains the single best way to preserve reproductive potential. “Patients undergoing cancer treatments need to be informed of the good news on the other side. There are sophisticated and effective ways to help men become fathers after the storm of cancer treatment has passed.”

© 2010 Lippincott Williams & Wilkins, Inc.
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