Value of clinical diagnosis in predicting the quality of cryopreserved sperm from cancer patients

Purpose: Cryopreservation of semen from patients with malignant diseases (primarily testicular cancer, Hodgkin's disease and lymphoma) before specific chemotherapy, radiation or surgical therapy has become a realistic option to preserve fertility. Nevertheless, the post-thaw sperm quality in these patients is poor. Whether the clinical diagnosis of malignancy affects the cryopreservation of human sperm is unknown. Such an association could allow post-thaw sperm quality to be predicted. Materials and Methods: We compared the effect of cryopreservation on sperm motility, velocity, linearity, amplitude of lateral head movement, motility index and motile sperm count in specimens from 30 normal men, 34 with testicular cancer, 39 with Hodgkin's disease, and 19 with leukemia and lymphoma who were referred for sperm banking during a 5-year period. Results: The pre-freeze and post-thaw motility, motility index and motile sperm count were significantly lower in all patients than in normal men (p <0.01). No significant differences were noted among the patient groups. Similarly, no significant differences were noted after cryopreservation. Our results indicate that the poor pre-freeze sperm quality in some patients with malignancies explains the poor post-thaw results. However, the deterioration in sperm function after cryopreservation of semen among patients with different malignancies and normal donors appears to be similar. Conclusions: Clinical diagnosis of malignancy is not an adequate predictor of the effect of cryopreservation on human semen.