STUDY QUESTION What is the natural history of elective autologous sperm cryostorage prior to gonadotoxic treatment? SUMMARY ANSWER We estimate large sample median times to transfer for use, to the man’s death or to discard of sperm, and their determinants, as the key operational outcomes of sperm cryostorage. WHAT IS KNOWN ALREADY No large sample studies of the natural history of sperm cryostorage prior to gonadotoxic treatment are reported. STUDY DESIGN, SIZE, DURATION This observational single-centre study covered 45 years of outcomes with a survival analysis for sperm cryostorage prior to scheduled gonadotoxic treatment, and its determinants. PARTICIPANTS/MATERIALS, SETTING, METHODS This study included 3923 men (mean age 30 years) who sought sperm cryostorage for a wide range of cancers and other diseases requiring gonadotoxic treatments. MAIN RESULTS AND THE ROLE OF CHANCE The median time to transfer for use (n = 371 men 9%) was 2.4 years (quartiles 1.0, 6.0), the median time to death (n = 553 men, 14%) was 1.7 (0.9, 3.3) years, and the median time to discard (n = 1807 men, 46%) was 7.7 (1.7, 11.1) years. In multivariate Cox model regression, the underlying disease, number of storage visits and follow-up visits, and whether sperm were seen at follow-up visits were consistent predictors of times to outcomes. LIMITATIONS, REASONS FOR CAUTION This study did not investigate sperm cryostorage for reasons other than gonadotoxic treatment, nor the fertilization outcomes of the cryostored sperm. WIDER IMPLICATIONS OF THE FINDINGS These data provide estimates of the key operational factors for sperm cryostorage programs, prior to potentially sterilizing gonadotoxic treatments, and free from financial or insurance restrictions. STUDY FUNDING/COMPETING INTEREST(S) There was no specific funding for this study. D.J.H. has provided expert witness testimony to antidoping and professional standards tribunals and is supported by an NHMRC Investigator Grant. The other authors have no disclosures. TRIAL REGISTRATION NUMBER N/A.

中文翻译：

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自体精子冷冻保存的自然史


研究问题 性腺毒性治疗之前选择性自体精子冷冻保存的自然史是什么？摘要答案 我们估计大样本从转移使用到男性死亡或丢弃精子的中位时间及其决定因素，作为精子冷冻保存的关键操作结果。已知信息 目前还没有关于性腺毒性治疗前精子冷冻自然史的大样本研究报道。研究设计、规模、持续时间 这项观察性单中心研究涵盖了 45 年的结果，对预定的性腺毒性治疗之前的精子冷冻保存及其决定因素进行了生存分析。参与者/材料、背景、方法 这项研究包括 3923 名男性（平均年龄 30 岁），他们寻求精子冷冻保存来治疗多种癌症和其他需要性腺毒性治疗的疾病。主要结果和机会的作用 转移使用的中位时间（n = 371 名男性，9%）为 2.4 年（四分位数 1.0，6.0），死亡的中位时间（n = 553 名男性，14%）为 1.7（0.9） , 3.3) 年，中位丢弃时间（n = 1807 名男性，46%）为 7.7 (1.7, 11.1) 年。在多变量 Cox 模型回归中，基础疾病、储存访问和随访次数以及随访中是否看到精子是结果时间的一致预测因素。局限性、注意原因本研究没有调查除性腺毒性治疗以外的原因的精子冷冻保存，也没有调查冷冻精子的受精结果。研究结果的更广泛影响这些数据提供了在潜在的性腺毒性绝育治疗之前精子冷冻保存计划的关键操作因素的估计，并且不受财务或保险限制。 研究资助/竞争利益 本研究没有具体资助。 DJH 向反兴奋剂和专业标准法庭提供了专家证人证词，并得到了 NHMRC 调查员补助金的支持。其他作者没有披露任何信息。试用注册号 不适用。