A recent study was just published by oncofertility researchers examining the effect of establishing a formal fertility preservation program on the number of male cancer patents who received a fertility preservation consultation and pursued sperm cryopreservation. Established sperm cryopreservation has been available at Northwestern University since 1999 but it wasn’t until 2005 that an oncofertility program was established.
The paper, “Improved Fertility Preservation Care for Male Patients With Cancer After Establishment of Formalized Oncofertility Program,” describes the Northwestern program that consists of a variety of tools to increase fertility care for young cancer patients. Seminars and grand rounds educate physicians and nurses in oncology and reproductive endocrinology. Provider knowledge gaps, logistical constraints, and economics concerns, which have previously been identified as barriers to fertility preservation, were addressed in the trainings. Patient materials in English and Spanish, as well as a hotline also provide information to the non-medical community. The hospital’s electronic medical record system was modified to ask physicians of new oncology patients whether fertility preservation was discussed. Interested patients could then be referred to the fertility preservation patient navigator and a subsequent consultation.
For male cancer patients, such as those identified in the study, a fertility preservation consultation occurs with a urology specialist who discusses the potential reproductive and sexual health impacts of cancer treatment. Options to preserve fertility, which include sperm cryopreservation, are also discussed. The patient navigator at Northwestern shepherds each patient throughout the fertility preservation process and integrates it within the oncology treatment.
In the study, Sheth, Sharma, Helfand, Cashy, Smith, Hedges, Köhler, Woodruff, and Brannigan reviewed cases of male cancer patients age 18-55. The number of fertility preservation consultations and procedures were identified between 2002 and 2012. Though the number of patients remained relatively constant across this time period, an average of more 22 patients per year were offered consultations prior to the implementation of the program compared with more than 64 per year afterwards. In addition, of male cancer patients age 18-40, the percentage offered a consultation increased from 23.4% to 43.3% during that time. Furthermore, the percentage of consulted patients who chose to undergo sperm cryopreservation increased from 77.9% to 90% after implementation of the program.
Prior to the onset of the program, male patients with leukemia/lymphoma or testicular cancer were most likely to bank sperm and the number of these patients increased between 2002 and 2010. However, patients with other types of cancers, such as those with brain, gastrointestinal, head and neck, prostate, and bone or soft tissue malignancies, were most increased after the oncofertility program began at Northwestern, indicating that the program successfully educated new oncology professionals to discuss fertility in the cancer context.
Though significant headway has been made in the past decade, the authors of the paper in the Journal of Urology, stress the need for continued efforts to further increase the numbers of young cancer patients that receive a fertility consultation. Read the entire article.