Worried About Azoospermia After Chemotherapy
Here is why you should Preserve sperm with zero risk of disease transmission for future use perticularly after chemotherapy. http://www.frozencell.org/blog/2018/03/16/preserve-your-sperm-with-zero-source-of-disease-transmission/
Since incidence of carcinoma is increasing in fertile age. Therefore use of chemotherapy is getting more common . Azoospermia After Chemotherapy means drastic reduction in sperm count after chemotherapy. Most importantly Azoospermia After Chemotherapy is irreversible in most of the case. Most of the time patients are aware about No-Sperm After Chemotherapy or Azoospermia After Chemotherapy. The person undergoing chemotherapy and his all near & dear one expect to have baby even after chemotherapy. Further they also hope that preserved sperms must be 100% safe for future use. For male here choice is to Preserve Sperm without HSA. http://www.frozencell.org/blog/2018/06/01/why-to-preserve-cryo-preserve-human-sperm-with-hsa-hsa-additional-source-of-disease-transmission/
Fertility After Chemotherapy
Since Azoospermia after Chemotherapy is a well known entity. Therefore every measure and precaution should be taken for safe sperm preservation. Presently human sperms are preserved with Human Serum Albumin (HSA). Rarely Avian protein (egg yolk) and Animal protein (Fetal bovine serum or FBS) are used in sperm freezing media. Hence aim of this post to make sperm preservation free from all possible future risk. Because addition of Human , animal or avian protein directly increase the risk of infection.
Human protein ( Human serum albumin or HSA) Human serum albumin is a plasma derived product. There are four major factors which decide the probability of viral disease (symptomatic or asymptomatic) after use of HSA.
Potential infectivity of starting material ( pooled blood or plasma)
Effectiveness of manufacturing process
Post manufacturing handling of the product
Immunological competence of recipient.
Even the FDA create a class warning for plasma products that states among other things that “the risk of transmission of infectious agents cannot be totally eliminated”.
At this point it is worth to point out that only number 1 and 2 factor can be controlled effectively. Factor 3 depends on many local factor . And factor 4 is very difficult to control any way. Even after taking all possible measure there is possibility of man made or mechanical mistake.
Avian Protein (Egg Yolk) During previous days use of this form of protein was very common. Even now a days some companies are trying to promote it in underdeveloped and developing country. It’s a matter of discussion that zoootics like avian flu, nipah virus can be transmitted by this route or not.
Animal protein (Fetal bovine Serum or FBS) This form of protein is not in use for human sperm preservation particularly because of Creutzfeldt Jakob disease (CJD). CJD is a rare degenerative, fatal brain disorder. CJD usually appears in later life and runs a rapid course. Most noteworthy early diagnosis of this deadly disease is still very difficult.
Chemotherapy & sperm production
There are other factors also which need consideration during sperm preservation before Chemotherapy.
Un-diagnosed & emerging viruses
Animal parvo-viruses indicate considerable heat resistance at 60 degrees C.
Role of Viral mutation may be an important factor, which seems to be theoretical. But it can increase the virulence & heat tolerance at any point of time.
Spores cannot be destroyed by pasteurization.
In case of pure vegetarian partner, she may refuge to be inseminated by HSA containing preserved sperm.
Immuno- compromised patient (recipient) have additional risk to get infected even by properly treated HSA.
Discussion – Obviously sperm should be preserved before chemotherapy. As chemotherapy , radiotherapy or surgical removal of testis results in azoospermia or no-sperm. The burning question how to preserve sperm? Since it is a matter to carry on a generation, all possible measure is required to make safe preservation of sperm. One of the safest option is to preserve sperm with 100% chemically defined sperm freezing media. Even efficacy and complication of recombinant albumin has to be established , secondly its production rate and cost should be considered. On other hand if sperm freezing media is 100% chemically defined and its all components are well known, sperm will be preserved with zero risk of disease transmission particularly in case of chemotherapy, radiotherapy or surgical removal of testis.