Cryopreservation, semen use and the likelihood of fatherhood in male Hodgkin lymphoma survivors: an EORTC-GELA Lymphoma Group cohort study

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TitreCryopreservation, semen use and the likelihood of fatherhood in male Hodgkin lymphoma survivors: an EORTC-GELA Lymphoma Group cohort study
Type de publicationJournal Article
Year of Publication2014
Auteursvan der Kaaij M.AE, van Echten-Arends J., Heutte N., Meijnders P., Abeilard-Lemoisson E., Spina M., Moser E.C, Allgeier A., Meulemans B., Lugtenburg P.J, Aleman B.MP, Noordijk E.M, Ferme C., Thomas J., Stamatoullas A., Fruchart C., Eghbali H., Brice P., Smit W.GJM, Sebban C., Doorduijn J.K, Roesink J.M, Gaillard I., Coiffier B., Lybeert M.LM, Casasnovas O., Andre M., Raemaekers J.MM, Henry-Amar M., Kluin-Nelemans J.C, Canc EOrg Res Tr, Adulte GEtud Lymph
JournalHUMAN REPRODUCTION
Volume29
Pagination525-533
Date PublishedMAR
Type of ArticleArticle
ISSN0268-1161
Mots-clésCryopreservation, Fertility, Hodgkin, lymphoma, Male
Résumé

{STUDY QUESTION: How does the successful cryopreservation of semen affect the odds of post-treatment fatherhood among Hodgkin lymphoma (HL) survivors? SUMMARY ANSWER: Among 334 survivors who wanted to have children, the availability of cryopreserved semen doubled the odds of post-treatment fatherhood. WHAT IS KNOWN ALREADY: Cryopreservation of semen is the easiest, safest and most accessible way to safeguard fertility in male patients facing cancer treatment. Little is known about what proportion of patients achieve successful semen cryopreservation. To our knowledge, neither the factors which influence the occurrence of semen cryopreservation nor the rates of fatherhood after semen has been cryopreserved have been analysed before. STUDY DESIGN, SIZE, DURATION: This is a cohort study with nested case-control analyses of consecutive Hodgkin survivors treated between 1974 and 2004 in multi-centre randomized controlled trials. A written questionnaire was developed and sent to 1849 male survivors. PARTICIPANTS/MATERIALS, SETTING, METHODS: Nine hundred and two survivors provided analysable answers. The median age at treatment was 31 years. The median follow-up after cryopreservation was 13 years (range 5-36). MAIN RESULTS AND THE ROLE OF CHANCE: Three hundred and sixty-three out of 902 men (40%) cryopreserved semen before the start of potentially gonadotoxic treatment. The likelihood of semen cryopreservation was influenced by age, treatment period, disease stage, treatment modality and education level. Seventy eight of 363 men (21%) used their cryopreserved semen. Men treated between 1994 and 2004 had significantly lower odds of cryopreserved semen use compared with those treated earlier, whereas alkylating or second-line (chemo)-therapy significantly increased the odds of use; no other influencing factors were identified. We found an adjusted odds ratio of 2.03 (95% confidence interval 1.11-3.73
DOI10.1093/humrep/det430