The clinical outcomes of sperm cryopreservation in chemotherapy patients at a public hospital in the Western Cape

Abstract

Background: Sperm cryopreservation is the standard method of fertility preservation for men undergoing gonadotoxic cancer treatment. Both malignancy and chemotherapy may impair spermatogenesis and reduce future reproductive potential. Limited evidence exists on sperm cryopreservation outcomes among South African cancer patients.
Aim: To evaluate the clinical outcomes of sperm cryopreservation in cancer patients undergoing fertility preservation.
Setting: An andrology laboratory at a public hospital in the Western Cape, South Africa.
Methods: A retrospective quantitative study reviewed medical records of male cancer patients who underwent sperm cryopreservation between 2002 and 2021. Data collected included referral patterns, cancer diagnoses, pre-treatment semen parameters and the usage and disposal of cryopreserved sperm. Descriptive and inferential statistics were used to compare outcomes across cancer groups. Statistical significance was set at p < 0.05.
Results: A total of 126 patients underwent sperm cryopreservation. The mean age at diagnosis was 26.6 ± 7.0 years. Testicular cancer (27.4%), lymphoma (25.2%) and leukaemia (19.0%) were the most common diagnoses. Significant differences in semen volume were observed across cancer types (p = 0.015). Thyroid cancer and severe aplastic anaemia were associated with the lowest sperm concentration and motility values, although not statistically significant. Only three patients (2.38%) utilised their cryopreserved sperm, while 24 (19.05%) discarded stored specimens (p < 0.001).
Conclusion: Fertility preservation should be routinely discussed with eligible cancer patients before treatment. The low utilisation rate highlights the need for long-term monitoring of fertility preservation outcomes in cancer survivors.
Contribution: This study provides the first South African analysis of sperm cryopreservation outcomes in cancer patients and contributes evidence to inform fertility preservation practice and policy.