Two M. D. Anderson Studies Show Oncologists Should Offer Sperm Banking More Often to Younger Men
M. D. Anderson News Release 05/06/02
Men diagnosed with cancer who eventually may want to be fathers should learn about sperm banking from their doctors before treatment, according to two recent studies at The University of Texas M. D. Anderson Cancer Center published in a recent Journal of Clinical Oncology.
"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 Dr. Leslie R. Schover, 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."
To help prevent infertility that may result from treatment for several types of cancer, men may cryropreserve - freezing at extremely low temperatures - their sperm for in vitro fertilization or other infertility treatments at a later time. 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.
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, according to findings from a survey of 162 physicians at two cancer centers and in community practices. Researchers at Baylor College of Medicine and The Cleveland Clinic collaborated with M. D. Anderson for the two studies.
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, according to study findings.
"Physicians reported several barriers to offering sperm banking, including lack of time for discussion, perceived high cost and lack of convenient facilities," Dr. Schover says. "They overestimated sperm banking costs, as well as the number of sperm samples needed for adequate cryopreservation."
Additionally, oncologists reported they were less likely to offer sperm banking to men who were homosexual, HIV-positive, had a poor prognosis or had aggressive tumors, according to Dr. Schover.
In a concurrent survey of male patients aged 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," Dr. 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, Dr. 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.
Patients whose sterility may be compromised and who may want children in the future should ask their doctor about sperm banking before beginning cancer treatment.