“Just what the doctor ordered”: Factors associated with oncology patients’ decision to bank sperm

Abstract

Introduction: The purpose of this cross-sectional study was to explore factors associated with oncology patients' decision to bank sperm prior to cancer treatment. Materials and Methods:Patients who were referred to the oncology sperm banking program between January 2009 and March 2010 were invited to complete an 18-item questionnaire during one of their sperm banking visits. Results: Of the 157 cancer patients referred to the Mount Sinai Oncology Sperm and Tissue Bank for sperm banking during the 15-month period, 79 questionnaires were returned (50% response rate). Of the respondents, 89% were informed about sperm banking by their physician. Future family planning was cited as the main reason to bank. Cost was not a barrier for the vast majority of respondents. Forty percent of respondents banked sperm within 4 days prior to initiating cancer treatment. Most respondents relied on their physician for verbal information on sperm banking. Eightyone percent were unaware of any patient organizations that have educational materials on oncology fertility preservation. Conclusion: Sperm banking prior to cancer treatment is the only proven method of preserving fertility for cancer patients. The two main determinants associated with deciding whether to bank sperm were: the physician's recommendation and the patient's desire for future fatherhood. Physicians play a key role in influencing patients' decisions. The recommendation to bank sperm is a persuasive message if patients are clearly informed about their potential risk of infertility post-cancer treatment, and that sperm banking is an effective way of preserving fertility. Providing patients with education materials might enhance compliance in sperm banking. RésuméIntroduction : Le but de cette étude transversale était d'explorer les facteurs influant sur la décision des patients atteints de cancer de mettre du sperme en banque avant un traitement anticancéreux. Matériel et méthodologie : Les patients qui ont été orientés vers le programme de conservation de sperme pour patients cancéreux entre janvier 2009 et mars 2010 ont été invités à remplir un questionnaire à 18 questions au cours d'une de leurs visites à la banque de sperme. Résultats :Sur les 157 patients cancéreux orientés vers la banque de sperme et de tissus du Mount Sinai Hospital pour la mise en banque de sperme durant la période de 15 mois, 79 ont retourné un questionnaire (taux de réponse de 50 %). De ces répondants, 89 % avaient reçu des informations sur la banque de sperme de la part de leur médecin. La planification familiale était mentionnée comme la principale raison d'utiliser la banque. Le coût n'était pas un obstacle pour la grande majorité des répondants. Quarante pour cent des répondants ont mis du sperme en banque dans les quatre jours précédant le début du traitement anticancéreux. La plupart des répondants avaient reçu des informations verbales de leur médecin sur la mise en banque de sperme. Quatre-vingt-un pour cent n'étaient pas au courant s'il existait des organisations de patie...

A national study of the provision of oncology sperm banking services among Canadian fertility clinics

“…; Yee et al . ). Sperm banking referrals are generally made directly by oncology teams, or in conjunction with patients and families by providing them with banking information.…”

Rates of risk‐reducing surgery in Israeli BRCA1 and BRCA2 mutation carriers

“…In this study, the uptake of mastectomy was greater if the recommendation was reinforced by the primary caregiver. The impact of the recommendation of the health‐care provider has been shown to be important in other cancer‐related settings, such as prostate cancer patients' decision to opt for active surveillance vs surgery , and decisions regarding sperm banking prior to therapy .…”

Oncofertility in Canada: An Overview of Canadian Practice and Suggested Action Plan

“…The upfront costs for gamete preservation in women tend to be much higher; they are less commonly prohibitive for men 25,44 . Socioeconomic class and, particularly for younger patients, financial dependence on family may play a strong role in managing fertility preservation expenses 4 .…”

“…A single verbal communication in the already overwhelming context of a cancer diagnosis may not be the easiest way for patients to understand, digest, and retain information. Indeed, in a Canadian study of male fertility patients undergoing sperm-banking (79 respondents, 50% response rate), 81% said that they were unaware of any education resources on fertility preservation beyond the information verbally provided by their physicians 25 . Even within the context of fertility centres, 25% of responding women and 29% of responding men said that the centres in Canada do not provide any educational materials on fertility preservation 2 .…”

“…Among 1093 postpubertal patients, male and female, the rates of physician-led fertility preservation discussions varied from as low as 34% to 86% [26][27][28][29] . Furthermore, patients rely on endorsement from their oncology health care providers in deciding whether to pursue fertility preservation 25,27,30 , even with multiple knowledge resources in place 31 .…”