Fertility Preservation Discussion in Adult Male Cancer Patients Is Underutilized and Varies Based on Age

Abstract

Introduction. Oncofertility is often omitted in pretreatment discussion and planning. This study seeks to evaluate the prevalence and influencing factors of cryopreservation discussions. Methods. A retrospective review was performed on 3,133 male patients aged 18-60 years with a cancer diagnosis at a single institution. Data was collected for cryopreservation discussion and if cryopreservation of sperm was performed. Age, race, cancer location, primary treatment, and chemotherapy status were also recorded. Results. A total of 2,504 patients were included for analysis. There was documentation of counseling in 14.1% and 5.0% underwent cryopreservation. Logistic regression indicated a significant effect of age, race, site of cancer, primary treatment, and chemotherapy treatment on whether cryopreservation was discussed (χ 2 < 0.001). Age and chemotherapy at any time of treatment (P < .001) were significantly associated with cryopreservation counseling. Conclusion. Our study indicates that cryopreservation is vastly under-discussed, especially in older patients and those who do not receive chemotherapy. It is important to include preservation options and counseling for all patients.

Effect of Distance From Fertility Center on Utilization of Fertility Preservation Referral in Men

“…Identifying barriers to FP is vital as cancer survivorship improves and FP techniques advance. Perhaps the most critical barrier is still that of low referral rates 2,5 ; however, the establishment of formal oncofertility programs nationwide has promisingly led to increased referrals. 15,16 A unique characteristic of our study is that it only includes men who were referred for FP, thereby eliminating the most prevalent confounding variable from our analysis.…”

“…Contemporary studies have demonstrated that , 30% of eligible men are referred for FP and , 15% eventually cryopreserve sperm. 2,5,6 Numerous reasons for this underutilization have been proposed and generally fall into three categories: patient/family, provider, and institutional barriers. [7][8][9] For many patients, costs, severity of illness, and cultural or psychosocial factors may preclude timely cryopreservation.…”