Research Hospital
James Klosky, PhD, in a mock consultation Photo by Seth Dixon, St. Jude Children’s
New research suggests sperm banking may be underutilized by adolescent and young adult males with cancer who are at risk of infertility.
However, the study also showed that patients were more likely to attempt sperm banking if they were physically mature, met with fertility specialists, or their parents recommended sperm banking.
These findings were published in the Journal of Clinical Oncology.
“Research has found that the majority of males who survive childhood cancer desire biological children,” said study author James Klosky, PhD, of St. Jude Children’s Research Hospital in Memphis, Tennessee.
“Fertility preservation is also associated with a variety of benefits for survivors, including increased optimism about the future. While sperm banking is not for everyone, it is an effective method for preserving male fertility. Yet this study shows that sperm banking remains underutilized by at-risk patients with cancer.”
Dr Klosky and his colleagues surveyed 146 young males with cancer who were at risk of infertility. The researchers also surveyed 144 parents or guardians and 52 oncologists and other healthcare providers.
The patients’ mean age was 16.49 (range, 13.0-21.99). Diagnoses included leukemia and lymphoma (56.2%), solid tumor malignancies (37.7%), and brain tumors (6.2%).
Slightly more than half of the patients (53.4%, n=78) attempted sperm banking prior to starting treatment. Sixty-two, or 82.1%, of those who attempted sperm banking were successful.
In all, 43.8% of the patients successfully banked sperm.
Of the 68 patients who did not attempt sperm banking, 29 reported discussing the option with their families but deciding against it. Twenty-six patients indicated they did not believe sperm banking was necessary, and 9 patients were unsure what it was.
There were several factors that influenced the likelihood of patients making sperm collection attempts as well as successfully banking sperm.
In a multivariable analysis, the following factors were associated with an increased likelihood of attempting to bank sperm:
- Meeting with a fertility specialist (odds ratio[OR]=29.96; 95% CI, 2.48 to 361.41; P=0.007)
- Parent recommending banking (OR=12.30; 95% CI, 2.01 to 75.94; P=0.007)
- Higher Tanner stage (OR=5.42; 95% CI, 1.75 to 16.78; P=0.003).
In another multivariable analysis, successful sperm banking was associated with:
- Patient history of masturbation (OR=5.99; 95% CI, 1.25 to 28.50; P=0.025)
- Higher self-efficacy for banking coordination (OR=1.23; 95% CI, 1.05 to 1.45; P=0.012)
- Medical team member recommending banking (OR=4.26; 95% CI, 1.45 to 12.43; P=0.008)
- Parent recommending banking (OR=4.62; 95% CI, 1.46 to 14.73; P=0.010).
“These results highlight factors that providers can target to empower adolescents to actively participate in their own healthcare,” Dr Klosky said. “These decisions, which are typically made at the time of diagnosis, have high potential to affect their lives as survivors.”
