Oncologist and Sperm Banking Before Treatment

MedscapeWire Oncologists May Fail to Offer Sperm Banking Before Treatment

Laurie Barclay, MD

NEW YORK (MedscapeWire) Apr 15

Oncologists are sometimes remiss when it comes to discussing sperm banking before chemotherapy, according to 2 studies by the same group in the April 1 issue of the Journal of Clinical Oncology.

"All men who are about to receive cancer treatment that could impair fertility should be counseled about such side effects and given adequate information to make an informed decision about banking sperm," write Leslie R. Schover, PhD, from University of Texas M.D. Anderson Cancer Center in Houston, and colleagues.

In a postal survey yielding a sample of 201 male cancer patients aged 14 to 40 years, 51% expressed a desire to have children in the future, including 77% of men who were childless when cancer was diagnosed. Sixty percent of men were informed about infertility as an adverse effect of cancer treatment, and only 51% were offered sperm banking.

Twenty-four percent of men banked sperm, including 37% of childless men. Lack of information was the most common reason for failing to bank sperm, cited by 25%. Those who discussed infertility with their doctors were significantly more likely to bank sperm.

In a related study, 91% of physicians surveyed agreed that sperm banking should be offered to all men at risk of infertility from cancer treatment, but 48% acknowledged initiating a discussion on the topic with less than a quarter of eligible patients.

Reasons cited for not mentioning sperm banking included lack of time for the discussion, lack of convenient banking facilities, and high cost, although oncologists overestimated the costs of sperm banking and the number of samples needed. Physicians admitted they were less likely to offer sperm banking to men with homosexual orientation, HIV positivity, poor prognosis, or aggressive tumors.

"Sperm banking should be offered as an option to all men at risk of infertility because of their cancer treatment," the authors write. "Clearer practice standards could help oncologists increase their knowledge about sperm banking and avoid dependence on biased patient selection criteria."

J Clin Oncol. 2002;20(7):1880-1897

Reviewed by Gary D. Vogin, MD

MedscapeWire 2002. 2002 Medscape Portals, Inc

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