A survey of oncologists regarding sperm cryopreservation and assisted reproductive techniques for male cancer patients

BAGKGROUND, The authors surveyed the current knowledge, opinions, and clini cal practices of oncologists regarding pretherapy cryopreservation of semen from male cancer patients since the introduction of intracytoplasmic sperm injection (ICSI). METHODS. A survey was sent to all members of the American Society of Clinic al Oncology in Minnesota. RESULTS. Forty-six of 165 oncologists (28%) responded. Factors considered i mportant in how strongly to recommend cryopreservation were patient age at the time of diagnosis (94%), type of treatment (83%), type of cancer (65%), urgency to initiate treatment (63%), and preexisting infertility (57%). On cologists perceived patients to be significantly more concerned about cryop reservation than they were themselves during pretherapy counseling (P = 0.0 005). Oncologists estimated that 27% of their patients chose to cryopreserv e sperm. However, only 26% of the oncologists knew about ICSI. The cancers perceived to warrant cryopreservation the most were lymphomas, leukemias, a nd testicular carcinomas. The treatment modalities perceived to warrant cry opreservation the most were distributed among various chemotherapy and radi ation regimens. A majority of respondents to the survey knew where patients could go to cryopreserve sperm (89%), but less than half of the respondent s gave accurate information about the cost. CONCLUSIONS. Most of the oncologists surveyed were unaware of recent advanc es in reproductive technology in which only a few sperm are needed for succ essful in vitro fertilization with ICSI. This lack of awareness may be cont ributing to underutilization of sperm cryopreservation by male cancer patie nts. Currently, all male cancer patients of reproductive age who will have treatment that may affect testicular function and who may desire children i n the future should cryopreserve sperm before the initiation of therapy. (C ) 1999 American Cancer Society.