According to two recent articles published in the
Journal of Clinical Oncology, only half of young male patients who are to undergo treatment for cancer are offered the option of sperm banking prior to therapy.
Treatment of cancer is associated with many side effects, with specific agents or treatment regimens associated with particular side effects. One side effect that is common following many different treatment regimens for cancer, however, is infertility. Since infertility can be devastating for patients, particularly young patients with no children, researchers are investigating options to enable patients to have children following treatment for cancer that may result in infertility.
Male patients have the option of the collection and freezing of sperm prior to treatment, referred to as sperm banking. Collections of sperm are stored and can later be used for in-vitro fertilization, a procedure in which the stored sperm and eggs from a female are mixed in a laboratory and then implanted into the female’s uterus. The rate of a successful pregnancy and live birth are high following in-vitro fertilization; however, it is the responsibility of the physician to educate patients about sperm banking and offer it as an option for male patients diagnosed with cancer.
Researchers recently conducted a clinical study to determine the experiences of young male patients with cancer in regards to cancer-related infertility and sperm banking. In this study, 201 men diagnosed with cancer within the previous two years were surveyed and asked questions regarding their knowledge, attitudes and experiences with cancer-related infertility and sperm banking. According to the study, only 60% of men recalled being informed of infertility as a side effect of cancer treatment and only 51% recalled being offered the option of sperm banking. Those patients who discussed treatment-related infertility and sperm banking with their physician were much more likely to bank sperm and had greater knowledge of these issues. One-quarter of the men surveyed opted for sperm banking, including 37% of men without children. Lack of information of treatment-related infertility and sperm banking was most common reason that patients did not bank sperm.
These researchers also surveyed over 170 oncologists regarding their practices and attitudes of sperm banking in their young male patients who are diagnosed with cancer. Of these responders, 91% of oncology fellows and staff physicians agreed that treatment-related infertility and sperm banking should be discussed with eligible patients. However, 48% of fellows and physicians never discuss the subject, or discuss it with less than 25% of eligible patients. Neither the volume of patients or knowledge of sperm banking affected the likelihood of these discussions. In addition, the oncologists stated that barriers to discussion included lack of time, perceived high cost and lack of convenient facilities. Oncologists were less likely to offer sperm banking to patients who had a poor prognosis, aggressive cancer, were homosexual or HIV-positive. Oncologists generally overestimated the cost and number of samples needed for sperm banking.
The results from these two studies indicate that approximately half of eligible patients are offered sperm banking as an option prior to treatment for cancer. The researchers conducting these studies state that sperm banking should be discussed and offered to all eligible patients prior to undergoing therapy that would put them at a high risk of causing infertility.
1.Schover L, Brey K, Lichtin A, et al. Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. Journal of Clinical Oncology. 2002;20:1880-1889.
2.Schover L, Brey K, Lichtin A, et al. Oncologists’s attitudes and practices regarding banking sperm before cancer treatment. Journal of Clinical Oncology. 2002;20:1890-1897.
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