The birth of a baby boy, created using sperm frozen for a world-record 21 years, offers new hope to thousands of young people who may lose their fertility after cancer treatment, doctors said yesterday.
The child, born in 2002, could have been conceived in the year that Pol Pot's regime fell and Margaret Thatcher swept to power in Downing Street. But in 1979 his father was just 17 and facing treatment for testicular cancer. Many young men with cancer are in "emotional turmoil" said doctors yesterday and find it hard to think of a future where they might want children, but this 17-year-old came to the decision to freeze his sperm.
Yesterday doctors said they believed the baby's birth was a world first.
"We believe this is the longest period of sperm cryopreservation resulting in a live birth so far reported in the scientific literature," said Elizabeth Pease, a consultant at the department of reproductive medicine at St Mary's Hospital, Manchester, and one of the authors of a paper in the journal Human Reproduction published today.
The baby's parents, who have waited 10 years for a child, are "absolutely over the moon", said Dr Pease.
Some patients treated for testicular cancer will regain their fertility, but in this case, chemotherapy and radiotherapy between 1979 and 1981 caused the man to become sterile. From 1992, when he was discharged from treatment, he and his wife began to try for a family, but without success. Three years later, in 1995, they consulted Dr Pease.
"They were very worried about it from the start," she said, "about whether it was going to work in general. Their first concern was whether when it was defrosted, was the sperm going to be viable."
It was, but attempts to inseminate the woman failed and the couple were advised to try in-vitro fertilisation.
They joined the waiting list and three years later, in 1998, they were accepted for NHS treatment. In 1999 they had their first attempt at ICSI - the injection of a single sperm directly into the egg.
Three attempts resulted in the creation of embryos, but the embryos failed to implant in the womb.
On the fourth attempt, enough embryos were produced to allow three to be frozen. Two were thawed and transplanted into the womb in 2001. The woman became pregnant and had the baby in 2002.
Dr Pease pointed out that the couple were fortunate to have conceived on the fourth cycle, because their guidelines are to allow only three attempts, and the health secretary, John Reid, has said the NHS will only pay for one.
"If we had applied John Reid's new rules, this couple wouldn't have had a child," said Dr Pease. The man is now 42. If the couple want more children - they have one ampoule of sperm left - they will have to find the money to pay for private treatment.
Fertility experts and those who support young cancer patients will be encouraged by the case. The Human Fertilisation and Embryology Authority allows frozen sperm to be stored for 10 years, which is renewable if the man is under 55 and remains infertile.
But at the Manchester centre, only 27% of men use their frozen sperm before 10 years is up, suggesting that longer term studies of perhaps 25 years need to be done on frozen sperm. Although the first pregnancy from sperm frozen in dry ice was recorded in 1953 and the first from sperm frozen in liquid nitrogen was in 1964, little is known about the long-term effects of freezing.
Simon Davies, chief executive of the Teenage Cancer Trust, said he was delighted by the news. "We need to make sure that this treatment is made available to all teenagers with cancer," he said.
At a recent conference of over 400 teenagers with cancer, 66% said they had received no fertility counselling before they started treatment. Among those who had, 77% received it after treatment had begun when it can be too late to preserve sperm or eggs.
