Parental Hope Offered for Male Cancer Patients

Men diagnosed with cancer, and who also want to become fathers, should learn about sperm banking from their doctors before treatment.

Two studies at The University of Texas M.D. Anderson Cancer Center, published in a recent Journal of Clinical Oncology, recommend this measure. Researchers at Baylor College of Medicine and The Cleveland Clinic collaborated with M.D. Anderson for the studies.

"Many younger men are not getting the message that their cancer treatment may cause infertility, and they’re not being given information about sperm banking," says Leslie R. Schover, Ph.D., associate professor of behavioral science at M.D. Anderson and lead author of the two studies. "Male patients need to be told that if they want children at a later time, they have the option of banking their sperm before beginning cancer treatment."

Radiation therapy and chemotherapy for testicular cancer and Hodgkin’s disease – two of the most common cancers in men of reproductive age – may cause infertility. As a preventive measure, men may choose to cryropreserve (freeze at extremely low temperatures) their sperm for in vitro fertilization or other infertility treatments.

Findings from a survey of 162 physicians at two cancer centers and in community practices show that oncologists need updated information about costs and practicality of sperm banking, so they can offer the option of preserved fertility to men facing cancer treatment. Although 91 percent of oncologists agreed that physicians should offer patients the option of sperm banking, 48 percent said they usually failed to bring up the topic.

"Physicians reported several barriers to offering sperm banking, including lack of time for discussion, perceived high cost and lack of convenient facilities," Schover says. "They overestimated sperm banking costs, as well as the number of sperm samples needed for adequate cryo-preservation."

Additionally, Schover says oncologists reported they were less likely to offer sperm banking to homosexual or HIV-positive men, or those who had a poor prognosis or aggressive tumors.

In a concurrent survey of male patients age 14 to 40, researchers found that lack of information about sperm banking was the most common reason patients failed to preserve their sperm.

In the study of male patients, 51 percent reported wanting children in the future, including 77 percent of the men who were childless at the time of diagnosis.

"For these men, the cancer experience increased the value of family relationships, and they believed living through cancer would make them better parents," Schover says.

Sixty percent of the men remembered their doctor telling them about infertility as a treatment side effect, according to the study of patients. Fifty-one percent reported being offered sperm banking.

Although semen quality is often impaired by the time a man is diagnosed with cancer, newer techniques for in vitro fertilization require only one sperm to fertilize each egg. With good sperm quality and several frozen semen samples, a couple may achieve pregnancy with other techniques, such as artificial insemination, Schover says.

The number of sperm samples a patient can bank usually depends on the length of time before starting cancer treatment, sperm quality and the cost. Total cost for one ejaculate is about $400, which includes analyzing, freezing and a five-year storage fee.

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