Fertility counseling and sperm banking among adolescents and adults treated for cancer with curative intent in a developing country

Support Care Cancer. 2020 Aug;28(8):3915-3919. doi: 10.1007/s00520-019-05235-9. Epub 2019 Dec 19.

Abstract

Purpose: In developing countries, a higher percentage of patients develop cancer at a younger age. Cancer survival rates have significantly improved, highlighting the importance of survivorship programs that address late complications related to cancer itself or its treatment. The purpose of this study is to estimate the prevalence of fertility counseling and sperm banking and related factors among at-risk males newly diagnosed with cancer and planning to receive a potentially curative anticancer therapy.

Methods: Medical records and hospital database of young male patients with newly diagnosed cancers and planned to start chemotherapy were reviewed for fertility counseling and sperm cryopreservation. Additionally, a self-administered questionnaire was utilized.

Results: A total of 186 patients, mean age 32.9 (range: 18-53) years, were included. Non-Hodgkin's lymphoma 59 (31.7%), leukemia 48 (25.8%), and Hodgkin's lymphoma 26 (14.0%) were the most common tumors encountered. A total of 129 (75.0%) respondents received fertility counseling prior to their treatment, and this rate was higher among patients with early-stage disease (82.4% vs. 58.1%, p = 0.038). However, sperm banking was performed by 33.1% of the whole study group but was significantly higher among single patients (53.4% vs. 17.7%, p < 0.001), those who had no children (51.8% vs. 14.3%, p < 0.001), and among highly educated patients (47.6% vs. 17.1%, p = 0.001). Patients failed to do sperm banking because they were not informed about the risk of infertility (26.2%) or service availability (25.4%). Fear of treatment delay was a reason in 20.0%.

Conclusions: Fertility counseling and sperm banking among cancer patients are not optimal. Many patients failed to do sperm banking because of avoidable reasons. Better communication and patients' education will probably improve the utilization of this vital service.

Keywords: Cancer; Chemotherapy; Fertility; Sperm banking; Young male.

MeSH terms

  • Adolescent
  • Adult
  • Communication
  • Counseling / methods*
  • Cryopreservation / methods
  • Cryopreservation / statistics & numerical data
  • Developing Countries
  • Fertility Preservation / methods
  • Fertility Preservation / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Neoplasms / psychology
  • Semen Preservation / methods
  • Semen Preservation / statistics & numerical data
  • Sperm Banks / methods
  • Sperm Banks / statistics & numerical data*
  • Surveys and Questionnaires
  • Young Adult