Management of Fertility Preservation in Male Cancer Patients

Abstract

Cancer survival rates have improved dramatically over the last couple of decades due to advances in diagnostic techniques and therapies. Roughly 15% of newly diagnosed cancer cases are men aged younger than 55 years, and about one quarter of them are younger than age 20 years. Consequently, the population of young cancer survivors has improved, and the focus of cancer treatments has shifted from one of survival alone to that of survival and quality of life after cancer treatment. Male infertility due to cancer treatments may have temporary or permanent side effects. Because it is difficult-if not impossible-to predict the exact impact of cancer therapy on an individual man’s ability to father a biological child, sperm cryopreservation prior to therapy remains the cornerstone of fertility preservation. Banked sperm can be used in assisted reproductive procedures to initiate a successful pregnancy, thereby increasing the likelihood of male cancer patients fathering biological children. The American Society of Clinical Oncology (ASCO) advocates sperm cryopreservation as an effective method of fertility preservation in young men with cancer. However, the number of cancer patients utilizing sperm banking options remains low for a variety of reasons. In this chapter, we describe the incidence of cancer among adults and adolescents seeking fertility preservation before treatment, sperm banking techniques, and the challenges that limit the use of this technology among cancer survivors.