After cancer, many men don’t check fertility

U. SHEFFIELD (UK) — Many men are unaware of how cancer treatment affects their fertility over the long run and may limit their parenthood choices by failing to follow up with testing.

New strategies are needed to encourage men who have banked sperm prior to cancer treatment to engage with ongoing fertility monitoring programs, say researchers who present their research at the Fertility 2013 conference today. Their findings show that a large proportion of male cancer patients miss out on appropriate fertility advice.

Sperm banking is routinely recommended for all men diagnosed with cancer who are at risk of long-term infertility, caused by treatment such as chemotherapy and radiotherapy.

Infertility can be permanent or temporary depending on the individual’s circumstances and men may need to attend follow-up appointments to assess their fertility in the years after they have been discharged from cancer treatment.

These appointments are important to receive appropriate fertility advice and in light of current sperm banking regulations that state sperm samples should be disposed of after 10 years if ongoing infertility cannot be confirmed.

Allan Pacey, senior lecturer in andrology, and Christine Eiser, professor in psychology, of the University of Sheffield sent questionnaires to 499 male cancer survivors aged between 18 and 55 who had undergone cancer treatment more than five years ago and had taken the opportunity to bank sperm in either Sheffield or Nottingham.

The research, funded by Cancer Research UK, showed that of the 193 responses over a third of men (36 percent) had never attended a follow-up appointment to assess their fertility, with a further third (33 percent) only attending on one occasion.

“Trying to engage men with this subject is notoriously difficult, says Pacey. “For those of us who run sperm banks, many men store their sperm and then do not contact us again, even though there are legal reasons to keep in contact.”

“Our research suggests that there is a need to educate men about the benefits of attending follow-up fertility clinics and the long-term consequences of non-attendance.”

Non-attendance was found to be more likely in men who had suffered fewer side-effects at the time of treatment, had a more negative experience of banking sperm and had a more negative attitude to the disposal of sperm.

Missing follow-up appointments to monitor fertility means cancer survivors do not receive education and options available to them. In many cases, men may also be unaware their sperm may be disposed of if ongoing infertility cannot be confirmed. This could have a major impact on their future life choices and ability to father children.

The study shows new education strategies are urgently needed on an ongoing basis from the time of diagnosis to inform men about the importance of fertility monitoring as well as encouraging more men to attend these follow-up appointments, with patients receiving timely letters from clinics highlighting the benefits of attendance.

“Sperm banking is highly valued by men who want the option to have children once cancer treatment is completed,” explains Eiser.

“Our research found that many men do not know how cancer treatment can affect their fertility or the likelihood of fertility recovery over the long-term. Having received a cancer diagnosis, patients immediately need to take in a lot of information regarding treatments and side effects, and it can be challenging to discuss potential longer-term effects on fertility at this time.

“We therefore need a mechanism to ensure that men are given information about fertility issues at a later date and certainly before treatment ends.”

Source: University of Sheffield