Fertility preservation in adolescent males: experience over 22 years at Rouen University Hospital

BACKGROUND: Sperm banking is a suitable procedure to prevent infertilityafter cancer therapy in male adolescents. We evaluated the feasibilityof semen preservation in 156 adolescents aged between 13 and20 years and then we assessed fertility outcome after treatment. METHODS: Age, urogenital history, indications for cryopreservation, histologicaldiagnosis and semen parameters were recorded. Fertility statusafter treatment was assessed by a questionnaire addressed tothose patients who had utilized sperm storage. Post-treatmentsemen analysis was performed for 22 patients. RESULTS: Cryopreservation was possible in 88.5% of cases. Azoospermiawas detected in 2.6% of the patients at the time of diagnosis.Malignant disease accounted for 84% of our male adolescents.In this type of disease, semen parameters were significantlyaltered only among patients with metastatic malignant bone tumour.After treatment, nine patients presented azoospermia, five patientsachieved pregnancy spontaneously, two achieved it after assistedreproductive technique using fresh ejaculated spermatozoa andone following sperm donation. Three failed with cryopreservedsperm. CONCLUSIONS: Semen cryopreservation is possible for most adolescents and,regardless of disease type, may be a means of preserving fertilityprior to gonadotoxic treatment that might impair the spermatogenesisprocess.