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Simple Intervention Boosts Sperm Cryopreservation in Male Cancer Patients

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SAN FRANCISCO –An hour-long lecture by a fertility specialist during oncology grand rounds dramatically improves the rate of pretreatment sperm cryopreservation in young men with cancer, according to data presented at the American Urological Association (AUA) 2010 Annual Scientific Meeting.
The researchers, from the University of Wisconsin in Madison, found that a single lecture by a urologist specializing in male infertility increased sperm cryopreservation in male cancer patients fourfold.
“Even though our study was observational, our results highlight the importance of educating our colleagues in the oncology world about this resource,” Daniel H. Williams IV, assistant professor of urology and director of Male Reproductive Medicine and Microsurgery, said in an interview.
His team compared sperm cryopreservation rates before and after the lecture, which focused on the risks of treatment-induced male infertility, advances in assisted reproductive technology, and the local availability of sperm cryopreservation.
The dramatic increase in sperm cryopreservation seen a month after the lecture was maintained at follow-up several months later.
Because of therapeutic advances, pediatric and adult cancer survivors are living “well into” their reproductive years, Williams pointed out. Most cancer treatment regimens, however, have adverse effects on testicular function and male reproductive potential, and posttreatment fecundity is difficult to predict.  
Sperm cryopreservation provides an opportunity to preserve a man's fertility before cancer treatment, he said. In fact, the American Society of Clinical Oncology has recommended that oncologists routinely discuss the potential for infertility along with fertility preservation options with patients before cancer therapy and also refer interested patients to reproductive specialists. In addition, the guidelines recommend that semen cryopreservation be adopted as standard practice.
Epidemiologic studies indicate, however, that most young male cancer patients are not advised to bank sperm before their cancer treatment. Surveys have consistently identified a lack of information as the main reason for the low sperm cryopreservation rate.
About 40 health care personnel attended the lecture. Attendees were mostly pediatric and adult oncologists but also included oncology nurses and other staff.
In the 24-month period before the lecture, only one cancer patient per month banked sperm. After the lecture, the rate increased significantly to 3.7 cancer patients per month over the subsequent 7 months after the lecture (P < .0001).
Most of the change was due to a nearly sixfold increase in the number of nontesticular cancer patients, from .42 to 2.42 per month (P< .0001).
“With improvements in cancer therapies, young men of reproductive age who develop cancers—lymphomas, leukemias, and testicular malignancies, among others—are surviving longer,” Williams said. “As a result, cancer treatments now focus not only on survival but on quality of life, and fertility and fertility potential is a large component of quality of life after cancer treatment.”

Continued efforts should be made to educate health care professionals about sperm cryopreservation with an emphasis on improving the comprehensive cancer care and posttreatment quality of life in these patients, he added.