睪丸癌病人接受放射治療或化療後，須等1-2年精蟲染色體才可恢復正常，屆時才可接受IVF試管治療

Fertil Steril. 2017 Jan 6. pii: S0015-0282(16)63015-7. doi: 10.1016/j.fertnstert.2016.11.015. [Epub ahead of print]

Sperm aneuploidy after testicular cancer treatment: data from a prospective multicenter study performed within the French Centre d'Étude et de Conservation des Oeufs et du Sperme network.

Rives N1, Walschaerts M2, Setif V3, Hennebicq S4, Saias J5, Brugnon F6, Auger J7, Berthaut I8, Szerman E9, Daudin M10, Bujan L10.

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Abstract

OBJECTIVE:

To study sperm aneuploidy in a population of testicular cancer (TC) patients treated with the use of either bleomycin-etoposide-cisplatin (BEP) chemotherapy or radiotherapy.

DESIGN:

Multicenter prospective longitudinal study of TC patients analyzed before treatment and after 3, 6, 12, and 24 months (T3-T24).

PATIENT(S):

Fifty-four TC patients and a control group of 10 fertile sperm donors.

SETTING:

University hospital laboratories.

INTERVENTION(S):

Routine semen analyses; sperm aneuploidy and diploidy.

MAIN OUTCOME MEASURE(S):

Comparison of sperm characteristics and sperm chromosome abnormalities during TC patient follow-up.

RESULT(S):

Semen characteristics recovered pretreatment values 12 months after radiotherapy and 24 months after more than two BEP cycles. A significant increase in sperm disomy YY and XX was observed in the TC group before treatment compared with the control group. After more than two BEP cycles, the mean sperm aneuploidy rate increased significantly at T12 and reached the pretreatment value at T24. After radiotherapy, the mean sperm aneuploidy returned to the pretreatment value at T12. At T24, nearly 40% of TC patients did not recover their pretreatment sperm aneuploidy rate.

CONCLUSION(S):

Genetic counseling of TC patients should include information on the potential elevated risk of aneuploid conceptus from sperm recovered after treatment and the necessity to postpone conception up to ≥12 months after radiotherapy and ≥24 months after more than two BEP chemotherapy cycles. However, few men receiving one or two BEP cycles and some dropouts are the main limitations of this study.