Sperm DNA fragmentation in men with malignancy

Objective To determine if men with malignancy have increased sperm DNA fragmentation compared with men presenting for sperm donation. Design Retrospective observational study. Setting Tertiary-level fertility center. Patient(s) Eighty-nine men with cancer presenting for prophylactic semen cryopreservation and 35 men presenting for sperm donation. Intervention(s) None. Main Outcome Measure(s) Sperm DNA fragmentation index (DFI) measured by sperm chromatin assay. Result(s) The mean sperm DFI in men with a diagnosis of cancer, 9.88% (95% confidence interval [CI] 7.84%–12.44%), did not differ from that found in men presenting for sperm donation 10.46% (95% CI 8.68%–11.80%). There were no significant differences in mean sperm DFI within cancer subgroups or when comparing testicular and nontesticular cancers. Subgroup analysis lacked statistical power. Men with testicular cancer have significantly reduced sperm concentration compared with both control subjects and men with nontesticular cancer. Conclusion(s) In our study population there was no difference in sperm DFI between men undergoing prophylactic semen cryopreservation and men presenting for sperm donation. Sperm DFI assessment has limited utility in the routine evaluation of men presenting for semen cryopreservation.