Why don't some men with banked sperm respond to letters about their stored samples?

The goal of this study was to survey male patients aged 14 to 40 years at diagnosis and recently treated in two cancer centers to determine their knowledge, attitudes, and experiences regarding cancer-related infertility and sperm banking. A postal survey about cancer-related infertility and sperm banking was offered to 904 men diagnosed with cancer within the previous 2 years. Eight percent opted out of the study. The others were sent the survey, with a cover letter stating elements of informed consent. Although the return rate was only 27%, yielding a sample of 201 men, responders did not differ significantly from nonresponders by institution, age, ethnicity, or cancer site. Overall, 51% of men wanted children in the future, including 77% of men who were childless at cancer diagnosis. Despite some anxieties about their own survival and risks to their children's health, men felt that the experience of cancer increased the value they placed on family closeness and would make them better parents. Only 60% of men recalled being informed about infertility as a side effect of cancer treatment, and just 51% had been offered sperm banking. Those who discussed infertility with their physicians had higher knowledge about cancer-related infertility and were significantly more likely to bank sperm. Only 24% of men banked sperm, including 37% of childless men. Lack of information was the most common reason for failing to bank sperm (25%). All men who are about to receive cancer treatment that could impair fertility should be counseled about such side effects and given adequate information to make an informed decision about banking sperm.

Sperm cryopreservation before cancer chemotherapy is available for young patients with cancer. However, few patients bank their sperm. The authors evaluated by questionnaire the psychological impact of sperm cryopreservation. The authors cryopreserved the sperm of 111 patients with cancer for free at the Yokohama City University (Yokohama, Japan). For the current study, questionnaires were mailed to 66 patients whose sperm had been cryopreserved. Fifty-one patients (77.3%) with testicular carcinomas (n = 24), leukemia or malignant lymphoma (n = 19), or other cancers (n = 8) answered the questionnaire. The average age at collection and the period of sperm cryopreservation were 30.1 +/- 6.0 (mean +/- standard deviation) and 3.3 +/- 2.2 years, respectively. Many patients were informed of the deleterious effects of cancer chemotherapy and worried about infertility in the future. However, only half of the patients banked their sperm on their own initiative. Other patients followed their physician's instruction. Eighty percent of patients replied that sperm cryopreservation helped in the battle against cancer. Sperm banking especially was found to encourage every patient who banked sperm on their own initiative. After cancer chemotherapy, 70% of patients wanted to have a child. However, 60% of patients were worried about infertility in spite of having their sperm cryopreserved. No patients wanted to use cryopreserved sperm for fathering children if their spermatogenesis was restored. Sperm cryopreservation invigorated many patients with cancer after cancer treatments. The majority of patients recommended sperm cryopreservation to other cancer patients. Sperm cryopreservation encouraged young patients with cancer during and after cancer treatment. It should be recommended for all young patients with cancer. However, sperm cryopreservation did not eliminate their fear of infertility. (c) 2005 American Cancer Society.