O-263 Sperm parameters in cancer patients: the role of cancer and cancer diagnoses
Authors: Buckett W.M , Bellemare V 
Published: June 2022

Abstract

Study question
How do sperm parameters compare in various oncologic conditions when compared with controls? Is there an association between severity of the disease and sperm parameters?

Summary answer
Most cancer types appear to affect sperm parameters. Motility is reduced in all cancers, while sperm concentration is strongly diminished in testicular cancer.

What is known already
There is no actual consensus whether cancer is negatively associated with semen quality. Some studies have reported poorer sperm parameters in men with cancer, especially testicular cancer. Others have reported no differences in semen parameters of cancer patients when compared with patients with benign diseases. Furthermore, small studies have shown conflicting differences in sperm parameters when comparing across different cancer types.

Study design, size, duration
Academic single-centered, retrospective cohort study with men banking sperm for fertility preservation prior to undergoing chemotherapy. A total 965 patients with various cancer types, recently diagnosed, produced at least one sample for sperm cryopreservation between 2004 and 2020. Concentration and progressive motility were analyzed for each sample at the time of cryopreservation, before beginning the chemotherapy treatments.

Participants/materials, setting, methods
The first sample of each patient was kept for data analysis (n = 965). The control group were unselected homosexual male couples planning parenthood, without any known fertility impairment (n = 39). Cancers were grouped as: testis (n = 297), lymphoma (n = 285), leukemia (n = 79), sarcoma (n = 85), brain (n = 61), gastro-intestinal (GI) (n = 73), ear-nose-throat (ENT) (n = 24), and other (n = 52). The last group included cancers of such as kidney, prostate, melanoma, or lung cancer. T-test and Fisher-test were used for statistical analyses.

Main results and the role of chance
Patients with testicular cancer had significantly lower mean sperm concentration when compared to controls (30.5 vs 69.9 M/ml; p &lt; 0.01). Other groups showed similar concentration values when compared to controls. Furthermore 47% testicular cancer patients had oligospermia (as determined by WHO criteria) compared with 10% unselected controls (p &lt; 0.001)
However, sperm from patients with almost all types of cancer showed lower motility rates when compared to controls (31.5 to 35.0% vs 49.0%; p &lt; 0.001). The only group showing similar motility with controls was ENT cancers (41.1% vs 49%, p = 0.2). Similarly, sperm samples from all cancer groups showed higher proportions with asthenospermia (as determined by WHO criteria) when compared with controls (39.1%-54.7% vs 18%, p &lt; 0.01)
For individual cancer groups, comparing sperm parameters between patients who survived and those who died, there were no significant differences, suggesting the severity or stage does not modulate the effect of the cancer itself on the sperm.
Patients in the testis, lymphoma, leukemia, sarcoma and brain cancer groups were significantly younger than controls (25.3-29.1 vs 37.3 years old), while GI and ENT groups were similar to controls (37.4 and 36.5 vs 37.3). In the “other cancers” group, patients were significantly older than controls (44.4 vs 37.3).

Limitations, reasons for caution
The interpretation of the findings of this study is limited by the retrospective nature of the analysis and the potential for unmeasured confounding variables.

Wider implications of the findings
There is an association between abnormal sperm parameters in samples for pre-chemotherapy cryopreservation and all cancer types. This may affect the future likelihood of pregnancy. Young men with cancer need to be counselled that ICSI may be recommended should they need or choose to use their cryopreserved sperm.

Trial registration number
Not applicable