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Purpose  There is insufficient understanding of the effects of malignant diseases themselves and chemotherapy on semen quality and final fertility outcomes. Here, the authors focused on the patients with malignant diseases who cryopreserved sperm pre‐ or post‐chemotherapy for future fertility, and revealed how clinical settings can affect semen quality and final outcomes.    Methods  The authors reviewed the records of 257 patients with malignant diseases who cryopreserved sperm. Among 257 cases, 113 men with germ cell tumors (GCTs) and 111 men with hematological disorders (HDs) were included in this study. Twenty‐five patients who achieved successful outcomes using cryopreserved sperm were also analyzed.    Results  In the men with GCTs and HDs, respectively, differences were observed in age (28 vs 27 years), sperm concentration (32.6 vs 46.1 million/mL,  P  < 0.05), motility (42.2% vs 41.0%), and the rate of cryopreservation before chemotherapy (90% vs 59%,  P  < 0.0001). For successful pregnancies and deliveries, age at cryopreservation (30.0 vs 35.3 years,  P  < 0.05) and disease type (12/16 vs 3/9,  P  < 0.05) were significant factors.    Conclusions  Compared to patients with GCTs, those with HDs have a lower pregnancy and delivery rate, even though semen quality is higher. Disease type and age at cryopreservation are significant factors for successful outcomes.

Sperm cryopreservation: Clinical and fertility outcomes in male oncological patients with germ cell tumors or hematological disorders