New strategies needed to encourage male cancer survivors to consider future fertility

Sperm banking is routinely recommended for all men diagnosed with cancer who are at risk of long-term infertility, caused by treatment such as chemotherapy and radiotherapy.

Infertility can be permanent or temporary depending on the individual's circumstances and men may need to attend follow-up appointments to assess their fertility in the years after they have been discharged from cancer treatment.

These appointments are important to receive appropriate fertility advice and in light of current sperm banking regulations which state sperm samples should be disposed of after 10 years if ongoing infertility cannot be confirmed.

Dr Allan Pacey, Senior Lecturer in Andrology, and Professor Christine Eiser, Professor in Psychology, at the University of Sheffield sent questionnaires to 499 male cancer survivors aged between 18 and 55 who had undergone cancer treatment more than five years ago and had taken the opportunity to bank sperm in either Sheffield or Nottingham.

The research, funded by Cancer Research UK, showed that of the 193 responses over a third of men (36 per cent) had never attended a follow-up appointment to assess their fertility, with a further third (33 per cent) only attending on one occasion.

Dr Allan Pacey said: "Trying to engage men with this subject is notoriously difficult. For those of us who run sperm banks, many men store their sperm and then do not contact us again, even though there are legal reasons to keep in contact.

"Our research suggests that there is a need to educate men about the benefits of attending follow-up fertility clinics and the long-term consequences of non-attendance."

Non-attendance was found to be more likely in men who had suffered fewer side-effects at the time of treatment, had a more negative experience of banking sperm and had a more negative attitude to the disposal of sperm.

Missing follow-up appointments to monitor fertility means cancer survivors do not receive education and options available to them. In many cases, men may also be unaware their sperm may be disposed of if ongoing infertility cannot be confirmed. This could have a major impact on their future life choices and ability to father children.

The study shows new education strategies are urgently needed on an ongoing basis from the time of diagnosis to inform men about the importance of fertility monitoring as well as encouraging more men to attend these follow-up appointments, with patients receiving timely letters from clinics highlighting the benefits of attendance.

Professor Christine Eiser said: "Sperm banking is highly valued by men who want the option to have children once cancer treatment is completed.

"Our research found that many men do not know how cancer treatment can affect their fertility or the likelihood of fertility recovery over the long-term. Having received a cancer diagnosis, patients immediately need to take in a lot of information regarding treatments and side-effects and it can be challenging to discuss potential longer-term effects on fertility at this time. We therefore need a mechanism to ensure that men are given information about fertility issues at a later date and certainly before treatment ends."

More information: This research will be presented at Fertility 2013 at 16:45-17:15 on Thursday 3 January 2013. Research presented is based on: Pacey et al. 2012. Hum. Reprod. 27 (11): 3132-9 Eiser et al. 2011. Hum. Reprod. 26 (10): 2791-8

Provided by University of Sheffield