Case Report: Delivery of a healthy baby using fresh semen sample after less than 2 years post chemotherapy treatment
Chiou Fen Carine To (SG), Shaw Ni Amy Lee (SG), Mui Nee Lim (SG), Mei Jing Eunice Ong (SG), Puey Leng Tan (SG), Rui Shan Ruth Wong (SG), Su Ling Yu (SG)
[To] Singapore General Hospital, [Lee] Singapore General Hospital, [Lim] Singapore General Hospital, [Ong] Singapore General Hospital, [Tan] Singapore General Hospital, [Wong] Singapore General Hospital, [Yu] Singapore General Hospital
Context-Objective We report the delivery of a healthy baby using fresh semen sample following less than 2 years post chemotherapy treatment. There can be damage to the genetic makeup of sperm after chemotherapy. This damage is repaired by two years after therapy; however, the exact time to repair is unknown. Methods-Patients The patient came to seek IVF treatment after failing 4 fresh IVF cycles in a private hospital. She was 42 years old in 2015. Her husband was diagnosed with Stage IV MALT lymphoma in June 2013; he completed his chemotherapy in September 2014. She did her first IVF cycle in our Centre in February 2015 using her husband’s frozen semen sample that was stored just prior to chemotherapy. The semen motility, count and normal morphology was 64%, 22 X 106/ml and 1% respectively. Post-thawed motility was 25%. 9 eggs were collected, 5 injected and 2 fertilized. The embryos transferred were 6 cells grade 2 and 2 cells grade 3 on Day 3. She was not pregnant. Intervention She was back for another cycle in September 2015 with the same stimulation regime as her previous cycle. But in this cycle, the husband produced fresh sample for ICSI instead of using his frozen samples. The semen motility, count and normal morphology was 82%, 6 X106/ml and 3% respectively. Main Outcome Measure She was pregnant and delivered a healthy baby. Results: In the second cycle,10 eggs were retrieved, 9 injected and 3 fertilized. The embryos transferred were partially compacting grade 2 and 8 cells grade 2 on Day 3. Conclusions: The use of fresh semen sample certainly surpassed the use of frozen ones thereby increasing the chances of implantation. This is most likely due to sperm DNA damage after cryopreservation. The use of fresh semen less than 2 years post chemotherapy is possible to father a child. However, long term monitoring of the health of the child is necessary.