Reproductive prognosis in male patients with azoospermia at the time of cancer diagnosis

Objective: Fertility status evaluation in patients found azoospermic at the time of malignancy diagnosis. Design: Case series follow-up. Setting: University Hospital Sperm Banking service. Patient(s): Male cancer patients found azoospermic between 1986 and June 2000. Intervention(s): Patients were interviewed about their reproductive history and were invited for a free semen analysis. Main Outcome Measure(s): Pregnancy rate (PR) and percentage of patients with viable spermatozoa in the ejaculate. Result(s): Sixty-five patients were enrolled; 16 were lost at follow-up, 7 died, and 42 were followed to the end of the study. The median (range) time of follow-up for the 42 remaining patients was 9 years (2-14 years). Seventeen patients had wanted to father a child; 12 had a child (71%, 95% confidence interval [CI] 48%-88%). Semen analysis results were available in 11 patients. Resumption of spermatogenesis was documented in 9 cases (82%, 95% CI 53%-97%). Conclusion(s): Spontaneous fertility recovery is frequent in patients who are azoospermic at the time of cancer diagnosis.