Assisted Reproductive Techniques

The reproductive capacity of individuals undergoing malignancy treatment can be preserved by cryopre-serving the gametes and using assisted reproductive techniques (ART) when pregnancy is desired.33 When non-cryopreserved spermatozoa are used in combination with intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), clinical pregnancy rates of 30-40% per cycle and delivery rates of 30% can be expected at most reproductive clinics. On the other hand, cryopreserved sperm from cancer patients results in complete pregnancies in only 18% of cycles.34 Similarly, autologous cryopreserved embryos from in vitro-fertilized oocytes can be successfully implanted after cytotoxic therapy if the patient can undergo ovarian hyperstimulation before therapy.35

Men who remain azoospermic long after chemotherapy may benefit from testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection (ICSI). The potential for sperm retrieval is not clearly affected by the chemotherapy regimen or by the disease treated.36 Therefore, men should not be considered sterile despite prolonged non-obstructive azoospermia after undergoing chemotherapy.

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