Semen cryopreservation in adolescent and adult men undergoing fertility compromising cancer treatment: A systematic review

Abstract

Treatment‐related infertility is a common problem in cancer survivors. Semen cryopreservation is the most established option for male oncological patients wishing to preserve their fertility. We conducted a systematic review to analyse the existing literature regarding the frequency of offers and attempts of semen cryopreservation. We systematically searched MEDLINE and EMBASE for eligible literature without restrictions to language, study type or year of publication. Two authors independently screened and evaluated the citations for eligibility. Studies were included if they reported on pubertal or post‐pubertal patients at risk of fertility impairment prior to their cancer therapy. We excluded studies neither reporting the prevalence of offer nor attempt of semen cryopreservation. Possible factors for heterogeneity between the studies were examined by meta‐regression analyses. Out of 6,105 returned citations, 42 studies were included in the analysis. The prevalence of offer varied from 8% to 100% and corresponding attempts ranged from 3% to 79%, showing a vast heterogeneity with inconsistent reporting of influencing variables. Measured by the number of scientific publications, the awareness for fertility preservation is increasing while actual prevalences are diverse. In order to identify variables influencing offer and attempt prevalences, consistent reporting of a core set of factors is required.

Fertility-related information received by young women and men with cancer – a population-based survey

“…A greater proportion of men than women underwent FP procedures, in line with previous studies [17,22,31]. Public versus private health insurance has in previous studies been recognized as a significant factor for FP counseling [31][32][33][34], but cannot account for the present low rates of FP among female participants as FP is included in the tax-funded healthcare available for the whole population in Sweden. Among men, most of those informed about disease/treatment impact on fertility were also informed about and used FP, indicating that sperm cryopreservation is a routine procedure in the oncological setting.…”

Efficient pathway for men fertility preservation in testicular cancer or lymphoma: a cross-sectional study of national 2018 data

“…Studies analysing male fertility preservation (MFP) rate before TC or HL treatment are rare. Furthermore, in a systematic review, Valipour and al., recently showed a major heterogeneity in the designs of studies previously published on this question [ 21 ]. Indeed, a very wide range of MFP rates before TC or L treatment are described, which is mainly related to a variable definition of MFP rate: studies analysing the rate of sperm banking in cancer patients who were informed of MFP, generally report high MFP rates (73% in 166 TC patients [ 22 ], 69% in 35 TC patients [ 23 ]).…”

Cancer survivorship: Reproductive health outcomes should be included in standard toxicity assessments

“…Despite the concerns regarding the psychological impact of reduced fertility after cancer treatment, the use of sperm banking for young patients with cancer varies. In a systematic review analysing 42 studies from different countries that included patients with various primary tumours and across various ages at diagnosis (13e83 years), the range of patients offered cryopreservation varied from 8 to 100%, the proportion of all at-risk patients attempting cryopreservation varied from 3 to 79%, and the rate of acceptance varied from 13 to 87% [72]. Furthermore, even if sperm cryopreservation was covered by statutory national health insurance, cryopreservation rates may still be low [72], suggesting that removal of financial hurdles alone does not guarantee equal access to fertility preservation, and a range of health inequality barriers remain [8].…”