Freezing semen doubles chance for fatherhood after Hodgkin lymphoma

Men with Hodgkin lymphoma who want to become fathers after their cancer treatment have greatly increased chances of doing so if they have frozen and stored their semen samples beforehand, according to new research.

This is the first study to investigate the impact on fatherhood with patients who freeze their semen prior to cancer treatment. Researchers questioned 902 male survivors of Hodgkin lymphoma in five European countries (France, Belgium, The Netherlands, Italy, and Switzerland). Among the 334 who wanted to have children, the availability of frozen semen doubled their chances of doing so when compared with men who had not frozen their semen.

"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, availability of cryopreserved semen doubled the odds of successful fatherhood," said Marleen van der Kaaij, MD, who carried out the work while she was a PhD student at the University Medical Centre in Groningen, The Netherlands. The study was published in Human Reproduction (2013; doi:10.1093/humrep/det430).

She said the findings emphasize the importance of semen cryopreservation. "Cryopreservation should always be offered to all male patients about to undergo cancer treatment—even in situations where treatment should start urgently or where first-line treatment is not very toxic to fertility. Clinicians should realize the enormous impact of this cheap and simple procedure."

Among the 334 men who wanted to have children after their treatment, 206 (62%) became fathers without any medical assistance, but 128 (38%) were unable to achieve an unassisted spontaneous conception and needed medical help. Frozen semen was available for 99 (77%) of these 128 men; of these 99 men, 78 used the frozen semen and 48 succeeded in conceiving one or more children. Of the remaining 30 men, 27 failed to conceive any children and three had a child spontaneously without the frozen sperm.

"Twenty-three percent of men unable to conceive spontaneously did not have cryopreserved semen available and could not become fathers. Whereas, among men who did use cryopreserved semen, we found a success rate of 62% and several men were still in the process of fertility treatment at the time of the survey," said van der Kaaij.

The researchers found that 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% more likely to freeze their semen, and men aged older than 30 years were less likely to freeze semen than men younger than 30 years. 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 to freeze semen than men treated before 1984.

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