ORIGINAL ARTICLE Andrology
Monitoring fertility (semen analysis)
by cancer survivors who banked
sperm prior to cancer treatment
A.A. Pacey1,*, H. Merrick2, E. Arden-Close2, K. Morris1, L.C. Barton1,
A.J. Crook1, M.J. Tomlinson3, E. Wright2, R. Rowe2, and C. Eiser2
1Academic Unit of Reproductive and Developmental Medicine, Department of Human Metabolism, University of Sheffield, Level 4, The
Jessop Wing, Tree Root Walk, Sheffield S10 2SF, UK2Department of Psychology, University of Sheffield, Sheffield S10 2TP, UK3Fertility Unit,
Nottingham University Hospital, East Block, B Floor, Derby Road, Nottingham, NG7 2UH, UK
*Correspondence address. E-mail: email@example.com
Submitted on April 3, 2012; resubmitted on June 8, 2012; accepted on June 25, 2012
study question: What medical and psychological variables predict why men with banked sperm do not return for semen analysis
after their cancer treatment has ended?
summary answer: Men who decline the offer of semen analysis are less likely to have reported adverse side effects during cancer
treatment, and have a more negative experience of banking sperm and a more negative attitude towards disposal of their stored semen than
those who attend.
what is known already: Previous authors have noted that male cancer survivors seem reluctant to have their fertility tested after
their treatment has ended. Moreover, the utilization rates of banked sperm are very low (,10%) and the majority of samples are kept for
many years without being used.
study design, size and duration: A cross-sectional study of 499 cancer survivors who were sent a questionnaire about their
views on sperm banking, fertility and post-treatment semen analysis between April 2008 and December 2010.
participants and setting: Men (aged 18–55 years) who had banked sperm in Sheffield and Nottingham (UK) prior to gona-
dotoxic treatment for cancer more than 5 years previously.
main results and the role of chance: Completed questionnaires were received from 193 men (38.7% response rate)
whose samples had been banked for 9.18+3.70 years (range ¼ 4.94–26.21) and whose current age was 35.08+7.08 years (range ¼
21.58–54.34; mean+SD). One-third (35.8%) had never attended for semen analysis. In multivariate analysis, the odds of not attending
for semen analysis were significantly greater among men who did not experience adverse treatment side effects [odds ratio (OR) ¼ 5.72,
95% confidence interval (CI) ¼ 2.10–15.56], who reported a more negative experience of banking sperm (OR ¼ 1.82, 95% CI ¼ 1.17–
2.82) and a more negative attitude to disposal of their stored semen (OR ¼ 1.56, 95% CI ¼ 1.01–2.42).
limitations and reasons for caution: Only 38.7% of those eligible agreed to take part. We do not know the character-
istics of men who declined to take part, if they agreed to attend semen analysis without completing the questionnaire or whether they had
chosen to have semen analysis performed elsewhere (e.g. private sector). Some of the measures used (e.g. experience of banking sperm)
relied on men’s recall of events many years previously.
wider implications of the findings: New strategies are required to encourage these men to engage with fertility monitor-
ing programmes if sperm banks are to be used cost-effectively and men are to be given appropriate fertility advice.
study funding and competing interests: This paper was supported by funding from Cancer Research-UK to C.E., A.A.P.
and R.R. (C481/A8141). The views expressed are those of the authors. No competing interests declared.
Key words: cancer / semen cryopreservation / male infertility / psychology
& The Author 2012. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
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Human Reproduction, Vol.27, No.11 pp. 3132–3139, 2012
Advanced Access publication on August 27, 2012doi:10.1093/humrep/des300
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