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Delayed childbearing and female ageing impair assisted reproductive technology outcome in survivors of male haematological cancers

  • Paolo Emanuele Levi-Setti
  • Luciano Negri
  • Annamaria Baggiani
  • Emanuela Morenghi
  • Elena Albani
  • Valentina Parini
  • Luca Cafaro
  • Carola Maria Conca Dioguardi
  • Amalia Cesana
  • Antonella Smeraldi
  • Armando Santoro
Fertility Preservation

Abstract

Purpose

To analyse the impact of female characteristics on assisted reproductive technology outcome among male haematological cancer survivors.

Methods

A retrospective analysis of 93 haematological cancer survivors attending our tertiary referral fertility centre between June 1998 and June 2017 for achieving fatherhood with assisted reproductive technology treatments.

Results

A progressive increase in the median female age was observed during the study period (32.2 years until the year 2007 and 36.9 years from the year 2012). Fifty-five out of 93 patients were treated with intracytoplasmic sperm injection (ICSI) (113 ovarian stimulations, 108 ICSI procedures). Cryopreserved ejaculated sperm was used in 28 couples, fresh sperm in 19, and thawed testicular sperm in 8 couples. Mean female age at ovarian stimulation was 37.0 ± 4.7 years. Twenty-six pregnancies resulted in a full-term birth (23% per started ovarian stimulation; 43.6% per couple) and 33 children were born. No significant differences were observed according to source of sperm (fresh, frozen, testicular) and multivariate analysis confirmed that maternal age was the only variable inversely related to the cumulative delivery rate, being five times lower (15.7%) when the female partner was ≥ 40 years (OR = 0.22, 95% CI 0.06–0.77) vs. 58.3% with younger women (p = 0.0037).

Conclusions

Delayed childbearing and female ageing affect ICSI outcome in couples where the male is a survivor of haematological cancer. This topic should be discussed when counselling male cancer patients about fertility preservation.

Keywords

Assisted reproductive technology Haematological cancer Male infertility Delayed childbearing Sperm banks 

Notes

Acknowledgments

The authors thank Pasquale Patrizio, M.D., M.B.E., Yale University, Fertility Center, for helping in preparing this manuscript.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Paolo Emanuele Levi-Setti
    • 1
    • 2
  • Luciano Negri
    • 1
  • Annamaria Baggiani
    • 1
  • Emanuela Morenghi
    • 3
  • Elena Albani
    • 1
  • Valentina Parini
    • 1
  • Luca Cafaro
    • 1
  • Carola Maria Conca Dioguardi
    • 1
  • Amalia Cesana
    • 1
  • Antonella Smeraldi
    • 1
  • Armando Santoro
    • 4
  1. 1.Humanitas Fertility Centre, Department of Gynaecology, Division of Gynaecology and Reproductive MedicineHumanitas Research HospitalRozzanoItaly
  2. 2.Department of Obstetrics, Gynaecology and Reproductive SciencesYale University, School of MedicineNew HavenUSA
  3. 3.Biostatistics UnitHumanitas Research HospitalRozzanoItaly
  4. 4.Department of Medical Oncology & HematologyHumanitas Research HospitalRozzanoItaly

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