長期精子凍結保存の実施状況に関する全国アンケート調査

Abstract

全国大学および癌センターを中心とした泌尿器科に対し, 長期精子凍結保存に関するアンケート調査を行い, 90施設から有効回答が得られた(回収率86%)。1)施設内で長期精子凍結保存を実施していたのは26.7%で, 非実施施設の7割が個人病院に紹介している現状が明らかになった。また, 保存を実施している施設でも, 担当している診療科は産婦人科が主であった。2)生殖医療に関するセンター化を行っている一部の施設を除くと, 長期精子凍結保存における現在の泌尿器科医の主な役割は, 長期精子凍結保存の必要性や施設の紹介等に関する患者説明にあるものと思われた。しかし, 説明対象, 実施方法については施設間で差があり, 今後エビデンスに基づいた標準化が必要と考えられた。

Questionnaires were mailed to 104 urological departments in universities, colleges, and cancer centers in February 2008. Ninety institutions returned answers to the questionnaire. Sperm cryopreservation before chemotherapy was performed in 24 institutions (26.7%) mainly in the gynecological department, whereas the others introduced the candidates to other institutions including private hospitals and clinics. Fifty-eight institutes gave information about fertility preservation routinely to young patients with testicular cancer before chemotherapy. Urological doctors in 57 institutions (63%) had no experience in consultation of patients with hematological/pediatric malignancies for fertility-preservation. Among 24 institutions performing sperm cryopreservation before chemotherapy, 18 preserved motile sperm even if during chemotherapy, as well as before chemotherapy but 2 institutions replied that patients during chemotherapy were contra-indication for sperm cryopreservation. For the patients with azoospermia, 2 institutions replied they tried to preserve testicular sperm before chemotherapy. The fee for sperm cryopreservation was free in 10 institutions. This nation-wide questionnaire survey clarified that the systems and indications for sperm cryopreservation before chemotherapy were different among institutions.