BACKGROUND This study aimed to investigate barriers to sperm cryopreservation for patients with advanced germ cell tumors. METHODS We reviewed data collected from patients who underwent chemotherapy for advanced germ cell tumors in our institutions from 1996 to 2016. We divided sperm cryopreservation procedures into three steps: offering information about sperm cryopreservation, patients' decision making and sperm collection, and investigating the barriers in each step. RESULTS Of the 91 patients, 43 (47%) successfully completed sperm cryopreservation. Thirty (33%) patients were not offered information about sperm cryopreservation from the doctors. Nine patients (9.9%) were offered but declined preservation. Nine patients (9.9%) were not able to provide sperm because of azoospermia (5) and anejaculation (4). Among 43 patients who successfully provided sperm, 10 (23%) had their cryopreserved sperm used for 21 cycles of in vitro fertilization. Ten pregnancies and 7 fatherhoods were achieved. Thirteen patients (30%) had their cryopreserved sperm discarded without use, whereas 20 (47%) continued preserving their sperm for a median 12.5 years. CONCLUSIONS Not only offering proper information about sperm cryopreservation, but also shared decision making prior to chemotherapy, and considering fertility preservation before orchiectomy are imperative. The rate of use of preserved sperm was relatively high, but decision making for sperm disposal should also be supported.

中文翻译：

---

晚期生殖细胞肿瘤患者精子冷冻保存的障碍：20年的经验。

背景技术本研究旨在研究晚期生殖细胞肿瘤患者精子冷冻保存的障碍。方法我们回顾了1996年至2016年从我们机构接受化疗的晚期生殖细胞肿瘤患者收集的数据。我们将精子冷冻保存程序分为三个步骤：提供有关精子冷冻保存的信息，患者的决策和精子收集以及调查障碍的方法在每个步骤中。结果在91例患者中，有43例（47％）成功完成了精子冷冻保存。医生未向30名（33％）患者提供有关精子冷冻保存的信息。提供了9名患者（9.9％），但保存率下降。9名患者（9.9％）由于无精子症（5）和射精（4）而无法提供精子。在成功提供精子的43位患者中，有10位（23％）的冷冻保存精子用于21个体外受精周期。十次怀孕和七个父亲。13名患者（30％）不使用冷冻保存的精子被丢弃，而20名（47％）继续将精子保存了12.5年。结论不仅要提供有关精子冷冻保存的适当信息，而且还必须在化疗之前共同决策，并考虑在睾丸切除术之前保存生育能力。保留精子的使用率较高，但也应支持精子处置的决策。13名患者（30％）不使用冷冻保存的精子被丢弃，而20名（47％）继续将精子保存了12.5年。结论不仅要提供有关精子冷冻保存的适当信息，而且还必须在化疗之前共同决策，并考虑在睾丸切除术之前保存生育能力。保留精子的使用率较高，但也应支持精子处置的决策。13名患者（30％）不使用冷冻保存的精子被丢弃，而20名（47％）继续将精子保存了12.5年。结论不仅要提供有关精子冷冻保存的适当信息，而且还必须在化疗之前共同决策，并考虑在睾丸切除术之前保存生育能力。保留精子的使用率相对较高，但也应支持精子处置的决策。