Cryopreservation and semen quality in patients with Hodgkin's disease

BACKGROUND: Cryopreservation of semen from patients with Hodgkin's disease yields fewer motile sperm than from fertile men without Hodgkin's disease. However, although poor sperm quality and subfertility have been associated with Hodgkin's disease, whether the disease adversely affects sperm quality is not clear because many studies evaluated semen quality after chemotherapy or radiation therapy had begun. Furthermore, the effect of cryopreservation on semen quality in these patients is unknown. This study investigated pretreatment sperm quality and the effect of cryopreservation on semen quality in patients with Hodgkin's disease. METHODS: Specimens from 39 patients with Hodgkin's disease and 30 normal volunteers who underwent sperm banking over a 5-year period were analyzed. No patient had undergone chemotherapy or radiation therapy before sperm banking. The nitrogen vapor technique, using Test-Yolk buffer with glycerol as a cryoprotective agent, was used for cryopreservation. Prefreeze and postthaw motile sperm count (MSC) and motion characteristics, namely motility, curvilinear velocity (VCL), linearity, amplitude of lateral head movement (ALH), and motility index, were compared between the two groups. RESULTS: Prefreeze values for MSC (P = 0.0001), motility (P = 0.0001), motility index (P = 0.0001), and VCL (P = 0.0019) differed significantly between patients and donors. Except for linearity and ALH, postthaw sperm MSC, motility, VCL, and motility index decreased significantly (P = 0.0001) in both groups. However, the percentage decline in semen quality from prefreeze to postthaw values did not differ significantly between donors and patients. CONCLUSION: The pretreatment semen quality in patients with Hodgkin's disease is poor compared with that of normal fertile men. However, half the patients had a normal MSC, so a clinical diagnosis of Hodgkin's disease does not predict cryopreservation outcome adequately. Semen cryopreservation should be encouraged as a routine part of the therapeutic management of men of reproductive age who will undergo chemotherapy or radiation therapy for Hodgkin's disease.