An Assessment of Cryopreserved Semen and Testicular Tissue Collected Before and After Cancer Treatment Initiation.

Purpose: This retrospective cohort study assessed semen and testicular tissue quality from adult and adolescent cancer patients who had samples cryopreserved in the Cryobank of Charité-Universitätsmedizin before and/or after cancer treatment. Methods and Materials: Medical and cryopreservation data for all samples stored between 03/2004 and 05/2019 were collected retrospectively. Results: We included information on 601 samples cryopreserved from 506 cancer patients for whom oncologic treatment data were available. The majority of the samples were cryopreserved prior to cancer treatment (460/600, 77%, median 5 days before treatment). Semen quality had a predisposed reduction in those collected from adolescents with testicular and/or hematological malignancies. Analyses of the 140 (23%) samples cryopreserved after treatment initiation (median of 84 days) revealed decreased median concentration and motility following high gonadotoxic-risk treatment. Rate of oligoasthenozoospermia was comparable in samples collected prior to treatment with those provided during follow-up spermiograms within 1 year after treatment initiation (45.5% vs 45.5%). However, an increase was seen in samples collected 1-2 (9.1% to 90.9%) and 2-3 (50.0% to 100.0%) years after treatment initiation. Conclusion: Cancer diagnosis and treatment may impair spermatogenesis; therefore, patient counseling prior to cancer treatment by an oncologist and/or fertility specialist is crucial.

Sperm and testicular tissue cryopreservation and assisted reproductive technology outcomes in male cancer patients: a 15-year experience.

OBJECTIVE: To explore the characteristics of cancer patients who cryopreserved sperm/testicular tissue samples in the Cryobank of Charité-Universitätsmedizin Berlin between 2004 and 2019, and the ART utilization rate with associated outcomes. METHODS: Retrospective data were available for 506 cancer patients, of which 46 (9.1%) had used their samples for artificial reproductive technologies (ART). Corresponding cycle information was collected from external fertility centers. RESULTS: Our cohort included 53/506 (10.5%) patients aged < 18 years at diagnosis. While adolescents and adults mainly banked sperm, adolescents showed higher rates of testicular tissue cryopreservation before (11.8%, 6/51 vs. 6.4%, 26/406) and after treatment (16.7%, 4/24 vs. 7.8%, 13/167). At study conduction, storage had been ended for 44.8% (269/601) of samples. The majority of samples used for ART were requested within the first 3 years after cryopreservation (71.5%, 28/39, range = 0-12 years). Pregnancy rate was 51.4% (19/37 cycles), resulting in 11 singleton births, 3 twin pairs, and 4 miscarriages. CONCLUSION: With the new advantage of public health insurance coverage of fertility preservation (FP) in Germany, an increased utilization has already been noticed in our center, emphasizing the necessity of further knowledge for individual counseling. Adolescent cancer patients need to be addressed specifically, as these patients show especially low cryopreservation rates.

TP53 gene in blood plasma DNA of tumor patients.

Tumor-specific TP53 mutations are detectable in the blood plasma of tumor patients. Mutations of the TP53 tumor suppressor gene are risk factors for tumor progression. The objective of this work is to compare the presence of TP53 mutations in plasma-DNA before and after tumor treatment with the status of this gene in the tumor tissue sample. DNA was extracted from plasma samples of 25 patients with gastrointestinal tumors, and from paraffin-embedded tumor tissues from the same patients. Temperature gradient gel electrophoresis (TGGE) was performed for mutation screening of exons 5-8 of GC-clamped polymerase chain reaction products. Mutation-positive and wildtype gel bands from TGGE were cut and reamplified for fluorescence-labeled sequence analysis. The results of several mutation analyses were correlated with analysis of p53 autoantibodies in the same plasma. Mutation frequency (one or several mutations per sample) was 7.1% in blood plasma of tumor-free patients, 87.0% in tumor tissues, 78.6% in plasma before tumor treatment, and 36.8% after treatment. Fifteen of 22 mutations in tumor tissues of 13 patients also were detected in the same exons of plasma before treatment (68.2%). Mutations in plasma after treatment (2-684 days) were the same in 6 of 30 cases of tissue mutations only. Six of seven patients with mutations after treatment in their plasma had metastases. One patient was p53 autoantibody negative, but has a terminator mutation of codon 196 in tissue and in posttreatment plasma as well. Genetic analysis of plasma in tumor patients should be further developed, as it might be of prognostic value.