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Farnetani G, Vannucci M, Fino MG, Cioppi F, Rosta V, Palma M, Tamburrino L, Vinci S, Casamonti E, Degl'Innocenti S, Spinelli M, Abrardo C, Marchiani S, Lotti F, Muratori M, Riera-Escamilla A, Krausz C. Severe sperm DNA fragmentation may persist for up to 3 years after cytotoxic therapy in patients affected by Hodgkin lymphoma and non-Hodgkin lymphoma. Hum Reprod 2024; 39:496-503. [PMID: 38177083 DOI: 10.1093/humrep/dead269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
STUDY QUESTION Does sperm DNA recover from damage in all men after 2 years from the end of cytotoxic treatments? SUMMARY ANSWER The current indication of 2 years waiting time for seeking natural pregnancy after cytotoxic treatment may not be adequate for all men, since severe sperm DNA damage is present in a proportion of subjects even after this timeframe. WHAT IS KNOWN ALREADY Data in the literature on sperm DNA fragmentation (SDF) in lymphoma patients after cytotoxic treatments are scarce. The largest longitudinal study evaluated paired pre- and post-therapy (up to 24 months) semen samples from 34 patients while one study performed a longer follow-up (36 months) in 10 patients. The median/mean SDF values >24 months after therapy did not show significant differences but the studies did not explore the proportion of patients with severe DNA damage and the analysis was done on frozen-thawed samples. STUDY DESIGN, SIZE, DURATION In this study, 53 Hodgkin lymphoma (HL) and 25 non-Hodgkin lymphoma (NHL) post-pubertal patients were included over a recruitment period of 10 years (2012-2022). Among them, 18 subjects provided paired semen samples for SDF analysis at the three time points. SDF was evaluated in patients before (T0) and after 2 (T2) and 3 years (T3) from the end of, cytotoxic treatments (chemotherapy alone or in combination with radiotherapy). A cohort of 79 healthy, fertile, and normozoospermic men >18 years old served as controls (recruited between 2016 and 2019). PARTICIPANTS/MATERIALS, SETTING, METHODS SDF was evaluated on fresh semen samples (i.e. spermatozoa potentially involved in natural conception) from patients and controls using TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assay coupled with flow cytometry. SDF median values were compared between groups: (i) HL and NHL patients versus controls at the three time points; (ii) HL versus NHL patients at baseline; and (iii) patients at T0 versus T2 and T3. Severe DNA damage (SDD) was defined for SDF levels above the 95th percentile of controls (50%) and the proportion of patients with SDD at all time points was established. MAIN RESULTS AND THE ROLE OF CHANCE At T0, patients displayed higher median SDF than controls, reaching statistical significance in the NHL group: 40.5% [IQR: 31.3-52.6%] versus 28% [IQR: 22-38%], P < 0.05. Comparing SDF pre-treatment to that post-treatment, HL patients exhibited similar median values at the three time points, whereas NHL showed significantly lower values at T3 compared to T0: 29.2% [IQR: 22-38%] versus 40.5% [IQR: 31.3-52.6%], P < 0.05. The proportion with SDD in the entire cohort at T2 was 11.6% and 13.3% among HL and NHL patients, respectively. At T3, only one in 16 NHL patients presented SDD. LIMITATIONS, REASONS FOR CAUTION TUNEL assay requires at least 5 million spermatozoa to be performed; hence, severe oligozoospermic men were not included in the study. Although our cohort represents the largest one in the literature, the relatively small number of patients does not allow us to establish precisely the frequency of SDD at T2 which in our study reached 11-13% of patients. WIDER IMPLICATIONS OF THE FINDINGS Our data provide further insights into the long-term effects of cytotoxic treatments on the sperm genome. The persistent severe DNA damage after 2 years post-treatment observed in some patients suggests that there is an interindividual variation in restoring DNA integrity. We propose the use of SDF as a biomarker to monitor the treatment-induced genotoxic effects on sperm DNA in order to better personalize pre-conceptional counseling on whether to use fresh or cryopreserved spermatozoa. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by grants from the Istituto Toscano Tumori (ITT), Fondazione Ente Cassa di Risparmio di Firenze, the European Commission-Reproductive Biology Early Research Training (REPROTRAIN). C.K., G.F., V.R., and A.R.-E. belong to COST Action CA20119 (ANDRONET) which is supported by the European Cooperation in Science and Technology (www.cost.eu). The authors declare no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Ginevra Farnetani
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Matteo Vannucci
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Maria Grazia Fino
- Andrology, Female Endocrinology and Gender Incongruence Unit, University Hospital Careggi (AOUC), Florence, Italy
| | - Francesca Cioppi
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Viktoria Rosta
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Department of Gynecologic Oncology, Hungarian National Institute of Oncology, Budapest, Hungary
| | - Manuela Palma
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Lara Tamburrino
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Serena Vinci
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Elena Casamonti
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Selene Degl'Innocenti
- Andrology, Female Endocrinology and Gender Incongruence Unit, University Hospital Careggi (AOUC), Florence, Italy
| | - Matilde Spinelli
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Department of Andrology, Fundació Puigvert, Universitat Autonoma de Barcelona, Instituto de Investigaciones Biomedicas Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Chiara Abrardo
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Sara Marchiani
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Francesco Lotti
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Andrology, Female Endocrinology and Gender Incongruence Unit, University Hospital Careggi (AOUC), Florence, Italy
| | - Monica Muratori
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Antoni Riera-Escamilla
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Department of Andrology, Fundació Puigvert, Universitat Autonoma de Barcelona, Instituto de Investigaciones Biomedicas Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Csilla Krausz
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Andrology, Female Endocrinology and Gender Incongruence Unit, University Hospital Careggi (AOUC), Florence, Italy
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Farnetani G, Fino MG, Cioppi F, Riera-Escamilla A, Tamburrino L, Vannucci M, Rosta V, Vinci S, Casamonti E, Turki L, Degl'Innocenti S, Spinelli M, Marchiani S, Lotti F, Muratori M, Krausz C. Long-term effect of cytotoxic treatments on sperm DNA fragmentation in patients affected by testicular germ cell tumor. Andrology 2023; 11:1653-1661. [PMID: 36932666 DOI: 10.1111/andr.13429] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/21/2023] [Accepted: 03/06/2023] [Indexed: 03/19/2023]
Abstract
INTRODUCTION Testicular germ cell tumor is the most frequent neoplasia in men of reproductive age, with a 5-year survival rate of 95%. Antineoplastic treatments induce sperm DNA fragmentation, especially within the first year post-therapy. Data in the literature are heterogeneous concerning longer follow-up periods, and the large majority is limited to 2 years. OBJECTIVE To define the timing for the recovery of sperm DNA damage and the proportion of patients with severe DNA damage at 2 and 3 years from the end of therapy. MATERIALS AND METHODS Sperm DNA fragmentation was evaluated in 115 testicular germ cell tumor patients using terminal deoxynucleotidyl transferase dUTP nick end labeling assay coupled with flow cytometry before (T0 ) and 2 (T2 ) and 3 (T3 ) years post-treatment. Patients were divided based on the type of treatment: carboplatin, bleomycin-etoposide-cisplatin, and radiotherapy. For 24 patients, paired sperm DNA fragmentation data were available at all time-points (T0 -T2 -T3 ). Seventy-nine cancer-free, fertile normozoospermic men served as controls. Severe DNA damage was defined as the 95th percentile in controls (sperm DNA fragmentation = 50%). RESULTS Comparing patients versus controls, we observed: (i) no differences at T0 and T3 and (ii) significantly higher sperm DNA fragmentation levels (p < 0.05) at T2 in all treatment groups. Comparing pre- and post-therapy in the 115 patients, the median sperm DNA fragmentation values were higher in all groups at T2 , reaching significance (p < 0.05) only in the carboplatin group. While the median sperm DNA fragmentation values were also higher in the strictly paired cohort at T2 , about 50% of patients returned to baseline. The proportion of severe DNA damage in the entire cohort was 23.4% and 4.8% of patients at T2 and T3 , respectively. DISCUSSION Currently, testicular germ cell tumor patients are advised to wait 2 years post-therapy before seeking natural pregnancy. Our results suggest that this period may not be sufficient for all patients. CONCLUSION The analysis of sperm DNA fragmentation may represent a useful biomarker for pre-conception counseling following cancer treatment.
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Affiliation(s)
- Ginevra Farnetani
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | | | - Francesca Cioppi
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Antoni Riera-Escamilla
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- Department of Andrology, Fundació Puigvert, Universitat Autònoma de Barcelona, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Barcelona, Catalonia, Spain
| | - Lara Tamburrino
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Matteo Vannucci
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- University Hospital Careggi (AOUC), Florence, Italy
| | - Viktoria Rosta
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Serena Vinci
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Elena Casamonti
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Leila Turki
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | | | - Matilde Spinelli
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Sara Marchiani
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Francesco Lotti
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- University Hospital Careggi (AOUC), Florence, Italy
| | - Monica Muratori
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Csilla Krausz
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- University Hospital Careggi (AOUC), Florence, Italy
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Song SH, Lee TH, Her YS, Oh M, Shin DH, Heo Y, Kim DK, Kim DS. Semen quality and sperm DNA fragmentation in cancer patients undergoing sperm cryopreservation. Investig Clin Urol 2023; 64:489-494. [PMID: 37668205 PMCID: PMC10482665 DOI: 10.4111/icu.20220402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/16/2023] [Accepted: 06/08/2023] [Indexed: 09/06/2023] Open
Abstract
PURPOSE We compared semen quality and sperm DNA fragmentation in cancer patients who underwent sperm banking and controls who underwent sperm cryopreservation for assisted reproductive technology (ART). MATERIALS AND METHODS A total of 132 men, 65 cancer patients and 67 controls, were prospectively enrolled and performed sperm cryopreservation for fertility preservation from May 2019 to February 2021. Sperm quality was determined by measuring semen volume, sperm concentration, sperm motility, and sperm DNA fragmentation index (DFI). Sperm quality and sperm DFI were compared in cancer patients and controls. RESULTS The major cancers of the 65 cancer patients were leukemia (26.2%), testicular cancer (23.1%), and lymphoma (20.0%). Sperm concentration, sperm total motility, and sperm progressive motility were significantly lower in cancer patients than in controls. Sperm DFI was significantly higher in cancer patients than in controls (24.32%±15.69% vs. 19.11%±11.63%; p=0.033). After excluding 8 cancer patients who received chemotherapy before sperm banking, sperm concentration, sperm total motility, and sperm progressive motility were significantly lower in cancer patients than in controls, but there was no significant difference in sperm DFI for cancer patients and controls (23.14%±12.79% vs. 19.11%±11.63%; p=0.069). CONCLUSIONS Sperm quality was lower in cancer patients than in controls. There was no difference in the sperm DFI of cancer patients prior to chemotherapy and men presenting for sperm cryopreservation for ART. We recommend that all men who are planning cancer therapy should be offered sperm banking prior to gonadotoxic chemotherapy as a standard of fertility preservation.
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Affiliation(s)
- Seung-Hun Song
- Department of Urology, CHA Fertility Center Gangnam, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Tae Ho Lee
- Department of Urology, CHA Fertility Center Gangnam, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Young Sun Her
- Andrology Lab, CHA Fertility Center Gangnam, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Mihee Oh
- Andrology Lab, CHA Fertility Center Gangnam, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Dong Hyuk Shin
- Andrology Lab, CHA Fertility Center Gangnam, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Yohan Heo
- Department of Urology, CHA Fertility Center Gangnam, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Dae Keun Kim
- Department of Urology, CHA Fertility Center, Seoul Station, CHA University, Seoul, Korea
| | - Dong Suk Kim
- Department of Urology, CHA Fertility Center Gangnam, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
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Pening D, Constant M, Bruynbroeck M, Delbaere A, Demeestere I. Impact of cancer on cryopreserved sperm quality and fertility: A cohort study. Health Sci Rep 2022; 5:e726. [PMID: 35873394 PMCID: PMC9297376 DOI: 10.1002/hsr2.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Sperm quality at cancer diagnosis is often compromised by the disease and any given gonadotoxic treatment will further diminish fertility. Objectives Here, we aim to analyze the cryopreserved sperm quality according to the cancer types as well as the fertility outcomes. Methods Our study included all cancer patients who cryopreserved sperm over 20 years at Erasme Hospital Brussels (from 1999 to 2019). First sperm samples from 111 hematologic, 104 testicular, 19 prostate, 28 gastrointestinal, and 16 neurological cancer patients were compared. Results Oligozoo-asthenozoospermia was observed in 30% of the samples, including 19.33% with severe oligozoospermia (<5 million/ml). Our results showed a significant reduction in sperm concentration among testicular cancer (p < 0.01). No significant differences in progressive motility, sperm volume, and number of frozen straws were observed. Significant correlations were found between sperm concentration and cancer type (p <0.01) as well as patients' age (p <0.01). Twenty-eight cancer survivors returned for using their cryopreserved sperm (9.33%), fertilization rate was 60.5% and implantation rate was 29.6%. There was no correlation between sperm concentration and fertility outcomes. Conclusion Our results confirm the negative impact of cancer on sperm quality without affecting assisted reproductive technology (ART) success rate, which is utterly important as a male reproductive health perspective. All cancer patients should be counselled and offered fertility preservation options as a gold standard.
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Affiliation(s)
- David Pening
- Department of Obstetrics and Gynecology, Fertility ClinicCUB—Erasme HospitalBrusselsBelgium
- Research Laboratory on Human ReproductionErasme CampusUniversité Libre de BruxellesBrusselsBelgium
| | - Marnie Constant
- Department of Obstetrics and Gynecology, Fertility ClinicCUB—Erasme HospitalBrusselsBelgium
| | | | - Anne Delbaere
- Department of Obstetrics and Gynecology, Fertility ClinicCUB—Erasme HospitalBrusselsBelgium
| | - I. Demeestere
- Research Laboratory on Human ReproductionErasme CampusUniversité Libre de BruxellesBrusselsBelgium
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Paoli D, Pallotti F, Lenzi A, Lombardo F. Fatherhood and Sperm DNA Damage in Testicular Cancer Patients. Front Endocrinol (Lausanne) 2018; 9:506. [PMID: 30271379 PMCID: PMC6146098 DOI: 10.3389/fendo.2018.00506] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 08/13/2018] [Indexed: 01/28/2023] Open
Abstract
Testicular cancer (TC) is one of the most treatable of all malignancies and the management of the quality of life of these patients is increasingly important, especially with regard to their sexuality and fertility. Survivors must overcome anxiety and fears about reduced fertility and possible pregnancy-related risks as well as health effects in offspring. There is thus a growing awareness of the need for reproductive counseling of cancer survivors. Studies found a high level of sperm DNA damage in TC patients in comparison with healthy, fertile controls, but no significant difference between these patients and infertile patients. Sperm DNA alterations due to cancer treatment persist from 2 to 5 years after the end of the treatment and may be influenced by both the type of therapy and the stage of the disease. Population studies reported a slightly reduced overall fertility of TC survivors and a more frequent use of ART than the general population, with a success rate of around 50%. Paternity after a diagnosis of cancer is an important issue and reproductive potential is becoming a major quality of life factor. Sperm chromatin instability associated with genome instability is the most important reproductive side effect related to the malignancy or its treatment. Studies investigating the magnitude of this damage could have a considerable translational importance in the management of cancer patients, as they could identify the time needed for the germ cell line to repair nuclear damage and thus produce gametes with a reduced risk for the offspring.
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Kumar K, Lewis S, Vinci S, Riera-Escamilla A, Fino MG, Tamburrino L, Muratori M, Larsen P, Krausz C. Evaluation of sperm DNA quality in men presenting with testicular cancer and lymphoma using alkaline and neutral Comet assays. Andrology 2017; 6:230-235. [DOI: 10.1111/andr.12429] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 07/14/2017] [Accepted: 08/21/2017] [Indexed: 02/03/2023]
Affiliation(s)
- K. Kumar
- Centre for Public Health; Queen's University Belfast; Belfast Northern Ireland UK
| | - S. Lewis
- Centre for Public Health; Queen's University Belfast; Belfast Northern Ireland UK
| | - S. Vinci
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - A. Riera-Escamilla
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - M.-G. Fino
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - L. Tamburrino
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - M. Muratori
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | | | - C. Krausz
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
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Tamburrino L, Cambi M, Marchiani S, Manigrasso I, Degl'Innocenti S, Forti G, Maggi M, Baldi E, Muratori M. Sperm DNA fragmentation in cryopreserved samples from subjects with different cancers. Reprod Fertil Dev 2017; 29:637-645. [DOI: 10.1071/rd15190] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 09/14/2015] [Indexed: 12/19/2022] Open
Abstract
Sperm cryopreservation is widely used by cancer patients undergoing chemo- or radiotherapy. Evidence suggests that IVF outcome with cryopreserved spermatozoa from cancer patients is less successful. To determine whether sperm DNA fragmentation (SDF) is involved in the lower fertilising ability of cryopreserved spermatozoa of cancer patients, SDF was evaluated in thawed spermatozoa from 78 men affected by different cancers and 53 men with non-cancer pathologies. SDF was assessed by the terminal deoxyribonucleotidyl transferase-mediated dUTP–digoxigenin nick end-labelling (TUNEL), propidium iodide (PI), flow cytometry procedure, which allows determination of two different cell populations (PIbrighter and PIdimmer) and thus to determine the percentage of DNA fragmented sperm in both. PIdimmer spermatozoa are totally unviable, whereas PIbrighter spermatozoa with SDF may be motile and morphologically normal, having higher biological relevance in the reproductive process. We found that the proportion of DNA fragmented PIbrighter cells was significantly higher in thawed spermatozoa from cancer than non-cancer patients. Moreover, a positive correlation was found between the degree of DNA fragmentation and sperm motility in the PIbrighter population of spermatozoa from cancer patients that wasn’t seen in non-cancer patients. The results of the present study suggest that higher SDF levels may contribute to the lower IVF success of cryopreserved spermatozoa from cancer patients and that evaluation of SDF could complement genetic counselling as part of the routine management of cancer patients who seek fertility preservation.
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The Biochemical and Pathological Correlates of Successful Semen Cryopreservation From Patients With Testicular Cancer: A Single Tertiary Center Experience. Urology 2016; 88:76-80. [DOI: 10.1016/j.urology.2015.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 11/04/2015] [Accepted: 11/10/2015] [Indexed: 11/21/2022]
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Molnar Z, Mokanszki A, Kassai Bazsane Z, Bhattoa HP, Benyo M, Olah E, Jakab A. Sperm concentration, hyaluronic acid-binding capacity, aneuploidy and persistent histones in testicular cancer. Hum Reprod 2014; 29:1866-74. [DOI: 10.1093/humrep/deu179] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bujan L, Walschaerts M, Brugnon F, Daudin M, Berthaut I, Auger J, Saias J, Szerman E, Moinard N, Rives N, Hennebicq S. Impact of lymphoma treatments on spermatogenesis and sperm deoxyribonucleic acid: a multicenter prospective study from the CECOS network. Fertil Steril 2014; 102:667-674.e3. [PMID: 25044088 DOI: 10.1016/j.fertnstert.2014.06.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/16/2014] [Accepted: 06/02/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine consequences of lymphoma treatments on sperm characteristics and sperm DNA, and to evaluate predictors of sperm recovery. DESIGN Multicenter prospective longitudinal study of patients analyzed before treatment and after 3, 6, 12, and 24 months. SETTING University hospitals. PATIENT(S) Seventy-five Hodgkin lymphoma and non-Hodgkin lymphoma patients and a control group of 257 fertile men. INTERVENTION(S) Semen analyses, and sperm DNA and chromatin assessments. MAIN OUTCOME MEASURE(S) Comparisons of sperm characteristics before and after treatment. RESULT(S) Patients already had altered sperm characteristics before lymphoma treatment, with no identified risk factor. Sperm count, total sperm count, motility, and vitality decreased after treatment, with lowest values at 3 and 6 months. Twelve months after treatment, mean sperm count recovered to pretreatment values after doxorubicin, bleomycin, vinblastine, darcarbacine (ABVD) or ABVD+radiotherapy, but not after doxorubicin, cyclophosphamide, vincristine, prednisone (CHOP) or mechlorethamine, oncovin, procarbazine, prednisone (MOPP) chemotherapies. It was noteworthy that 7% of patients remained azoospermic at 24 months. After 24 months, Kaplan-Meier estimates showed that more than 90% of patients will recover normal sperm count after ABVD or ABVD+radiotherapy vs. 61% for CHOP chemotherapies. In multivariate analyses including diagnosis and treatment protocol, only pretreatment total sperm count was related to recovery. Compared with a control group, lymphoma patients had higher sperm chromatin alterations and DNA fragmentation before any treatment. After treatment, DNA fragmentation assessed by TUNEL assay and sperm chromatin structure assay decreased from 3 and 6 months, respectively, while remaining higher than in the control group during follow-up. CONCLUSION(S) Lymphoma patients had altered sperm DNA and chromatin before treatment. Lymphoma treatment had damaging effects on spermatogenesis. These data on both the recovery period according to treatment modalities and the pre- and post-treatment chromatin status of sperm are useful tools for counseling patients wishing to conceive.
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Affiliation(s)
- Louis Bujan
- Université de Toulouse, University Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group) and CECOS, Toulouse, France; Fédération Française des CECOS, France, Paris.
| | - Marie Walschaerts
- Université de Toulouse, University Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group) and CECOS, Toulouse, France
| | - Florence Brugnon
- Fédération Française des CECOS, France, Paris; Assistance Médicale à la Procréation, CECOS, Universitary Hospital Estaing, and Laboratoire Génétique Reproduction et Développement, Université d'Auvergne, Faculté de Médecine, Clermont-Ferrand, France
| | - Myriam Daudin
- Université de Toulouse, University Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group) and CECOS, Toulouse, France; Fédération Française des CECOS, France, Paris
| | - Isabelle Berthaut
- Fédération Française des CECOS, France, Paris; Service d'Histologie, Biologie de la Reproduction-CECOS, Hôpital Tenon, Paris, France
| | - Jacques Auger
- Fédération Française des CECOS, France, Paris; Département d'Histologie-Embryologie, Biologie de la Reproduction-CECOS, Site Port-Royal, Paris Centre University Hospitals, Paris, France
| | - Jacqueline Saias
- Fédération Française des CECOS, France, Paris; Laboratoire de Biologie de la Reproduction-Cecos, Hôpital La Conception, Marseille, France
| | - Ethel Szerman
- Fédération Française des CECOS, France, Paris; Unité de Biologie de la Reproduction-CECOS, Pole de Biologie, Universitary Hospital Côte de Nacre, Caen, France
| | - Nathalie Moinard
- Université de Toulouse, University Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group) and CECOS, Toulouse, France; Fédération Française des CECOS, France, Paris
| | - Nathalie Rives
- Fédération Française des CECOS, France, Paris; CECOS Biologie de la Reproduction, Universitary Hospital Rouen, and Gamétogenèse et Qualité du Gamète research group, Université de Rouen, Rouen, France
| | - Sylvianne Hennebicq
- Fédération Française des CECOS, France, Paris; Laboratoire d'Aide à la Procréation-CECOS, Laboratoire AGe, Imagerie, Modélisation, Équipe Génétique-Infertilité-Thérapeutique, Faculté de Médecine de Grenoble, Grenoble, France
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Sperm cryopreservation before testicular cancer treatment and its subsequent utilization for the treatment of infertility. ScientificWorldJournal 2014; 2014:575978. [PMID: 24587730 PMCID: PMC3919096 DOI: 10.1155/2014/575978] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 11/07/2013] [Indexed: 11/17/2022] Open
Abstract
Aims. In this study we report our results with storage of cryopreserved semen intended for preservation and subsequent infertility treatment in men with testicular cancer during the last 18 years. Methods. Cryopreserved semen of 523 men with testicular cancer was collected between October 1995 and the end of December 2012. Semen of 34 men (6.5%) was used for fertilization of their partners. They underwent 57 treatment cycles with cryopreserved, fresh, and/or donor sperm. Results. A total of 557 men have decided to freeze their semen before cancer treatment. Azoospermia was diagnosed in 34 men (6.1%), and semen was cryopreserved in 532 patients. Seminoma was diagnosed in 283 men (54.1%) and nonseminomatous germ cell tumors in 240 men (45.9%). 34 patients who returned for infertility treatment underwent 46 treatment cycles with cryopreserved sperm. Totally 16 pregnancies were achieved, that is, 34.8% pregnancy rate. Conclusion. The testicular cancer survivors have a good chance of fathering a child by using sperm cryopreserved prior to the oncology treatment, even when it contains only limited number of spermatozoa.
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Degl'Innocenti S, Filimberti E, Magini A, Krausz C, Lombardi G, Fino MG, Rastrelli G, Maggi M, Baldi E. Semen cryopreservation for men banking for oligospermia, cancers, and other pathologies: prediction of post-thaw outcome using basal semen quality. Fertil Steril 2013; 100:1555-63.e1-3. [DOI: 10.1016/j.fertnstert.2013.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/30/2013] [Accepted: 08/06/2013] [Indexed: 10/26/2022]
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