Preserving future fatherhood This service helps boys and men with cancer maintain their ability to father children.

Kazim Chohan, PhD (seated), leads Upstate’s Male Fertility Preservation Program, which came about through the efforts of Chohan and colleagues including pediatric oncologist Jody Sima, MD (standing); (and, not pictured) urologist JC Trussell, MD; oncologist Rahul Seth, DO; and pathology chair Robert Corona Jr., DO. (PHOTO BY ROBERT MESCAVAGE)

BY JIM HOWE

Some cancers, and some cancer treatments, can cause male reproductive damage. But a variety of techniques available through Upstate’s Male Fertility Preservation Program can help men with a cancer diagnosis or temporary or permanent infertility issue.

“Survival is the first thing on their mind. Not fertility,” says Kazim Chohan, PhD, director of Upstate’s andrology department, where the program is housed. “That’s precisely why this should be offered.” He says physicians should tell their patients about fertility preservation as soon as a cancer diagnosis is made. Some health insurers will pay for the service.

Males of almost any age who hope to one day father a child may be candidates for fertility preservation. This includes boys who have not yet reached puberty, whose parents must make the decision for him. Weekend appointments are available for patients undergoing emergency chemotherapy or radiation therapy.

Chohan comes from a family that has made careers studying reproduction in both humans and animals. His father was an expert in artificial insemination of livestock in Pakistan, and one of Chohan’s sons is studying reproductive matters. Chohan himself has worked on aspects of reproduction in humans and in mammals ranging from mice to water buffalo.

Frozen sperm cells should remain viable for several decades, he says, noting there is no scientific consensus on the time limit, but a sample frozen in 1971 was used in 2011 and resulted in a healthy baby. Freezing techniques have progressed to the point where he does not see a limit on the length of time a sample could be kept frozen.

Success rates for frozen sperm samples are comparable to those of fresh samples, he says, and there are no known risks of birth defects from using frozen sperm.

The samples are stored in sealed vials that prevent cross-contamination and can be shipped to fertility centers elsewhere, even overseas, in special canisters that stay cold for up to two weeks.

Using testicular tissue samples from young boys is a relatively new procedure that has so far only been used to produce animal offspring. Chohan believes the science is advancing rapidly enough that it will be a normal practice for humans within a decade. The testicular tissue, like the sperm samples, is frozen and stored in the andrology lab.

For fertility preservation questions, contact the andrology department at 315-464-6550.

Techniques available

Here’s what andrologist Kazim Chohan, PhD, and his staff offer at Upstate:

  • Sperm banking: Collecting and freezing semen in liquid nitrogen (cryopreservation) for future use is the standard and least expensive procedure to preserve male fertility. A basic semen analysis will evaluate the sperm to determine future options for assisted reproduction. Generally, three to five samples are needed for the best chance of achieving pregnancy.
  • Testicular sperm extraction: Men with no sperm in their semen due to blockage or other conditions can have sperm extracted directly from their testicles with a brief surgical procedure. The sample is then frozen.
  • Testicular tissue freezing: Still an experimental process, this involves surgically removing and freezing tissue from the testicles of boys not yet old enough to produce sperm. The hope is that this tissue could be used in the future, once the boys have matured, to either restore fertility or produce sperm.

Female options

Fertility preservation for women, including egg and embryo freezing, is also offered by Upstate in partnership with Boston IVF. Call 315-703-3050 for more information.

This article appears in the winter 2017 issue of Cancer Care magazine. Hear a radio interview/podcast with Chohan and Sima about how male fertility preservation works.

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