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• Factors affecting sperm banking for adolescent cancer patients
  Gulam Bahadur
  Published on: 20 March 2006

• Published on: 20 March 2006

  Factors affecting sperm banking for adolescent cancer patients

  • Gulam Bahadur, Consultant Clinical Scientist
  • Other Contributors:
    • Helen Spoudeas, Melanie C Davies, David Ralph

  Dear Editor,

  The recent publication on sperm banking in adolescent cancer patients raises important awareness of difficult and sensitive issues1. Our experience of 238 adolescent cancer patients also showed that the ability to bank sperm was age related with a mean age of 16.7 years in the 86% who banked sperm compared to 15.5 years in the 14% who were unsuccessful in banking 2. However, it was found that one f...

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  Dear Editor,

  The recent publication on sperm banking in adolescent cancer patients raises important awareness of difficult and sensitive issues1. Our experience of 238 adolescent cancer patients also showed that the ability to bank sperm was age related with a mean age of 16.7 years in the 86% who banked sperm compared to 15.5 years in the 14% who were unsuccessful in banking 2. However, it was found that one factor that may be responsible for an adolescent not being able to produce a sample to freeze was being accompanied by a parent or guardian (RR=3.689, 95% confidence interval; 2.0-6.9). Similar studies allude to this effect3-4. The paper reviewing 205 adolescent and young adult cancer patients, aged 12 - 20 years who successfully banked sperm for future use showed that sperm was banked from all age groups, although the quality was generally poorer than healthy sperm donors, presumably due to their disease effect. This was particularly noticeable in patients with AML 5. The authors suggest that some sperm was not banked because the sample was not suitable for cryopreservation . With the advent of ICSI even very poor quality sperm should be stored, even if collected from a urine sample in those that cannot produce an ejaculated sample. With regards to consent, we believe that it is the quality of the informed consent that is important and not the grade or type of health professional involved. Counselling by experienced laboratory staff has proved beneficial, alongside that performed during the patient consultation. The technique of rectal electroejaculation in peripubertal boys has to be performed under general anaesthesia and may not be successful if full spermatogenesis has not been attained. There are also issues about consent for this technique in cultures where masturbation is forbidden 6. We agree that sperm banking should be offered routinely to all post- pubertal males and even to peri-pubertal boys in order to give patients the opportunity of future fertility.

  Gulam Bahadur

  Royal Free and University College Medical School and UCLH Trust,
  Department of Obstetrics & Gynaecology, Fertility &
  Reproductive Medicine Laboratories
  25 Grafton Way
  London
  WC1E 6HX

  g.bahadur@ucl.ac.uk

  Helen Spoudeas

  Neuro Endocrine & Late Effects Service
  250 Euston Rd
  UCLH Trust
  London
  NW1 2PQ

  Melanie C Davies

  Reproductive Medicine Unit
  UCLH Trust
  Huntley Street
  London
  WC1E 6DH

  melanie.davies@uclh.nhs.uk

  David Ralph

  Institute of Urology
  UCLH Trust
  Maple House
  Tottenham Court Rd
  London
  WC1

  Correspondence to: Dr G Bahadur

  References:

  1. Edge B, Holmes D. Makin G. Sperm banking for adolescent cancer patients. Arch Dis Child 2006, 91 149-152.

  2. G. Bahadur, KLE Ling, R Hart, D Ralph, V Riley, R. Wafa, A Ashraf, N Jaman, AW Oyede, 2002, Semen production in adolescent cancer patients. Hum Reprod., 17, 10, 2654-2656

  3 . Schover LR, Brey K, Lichtin A, et al. Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. J Clin Oncol 2002;20:1880–9.

  4. Schover LR, Brey K, Lichtin A, et al. Oncologists’ attitudes and practices regarding banking sperm before cancer treatment. J Clin Oncol 2002;20:1890–7.

  5. G. Bahadur, KLE Ling, R Hart, D Ralph, R. Wafa, A Ashraf, N Jaman, S. Mahmud, AW Oyede, 2002, Semen quality and cryopreservation in adolescent cancer patients. Hum Reprod., 17, 12, 3157-3161.

  6. Bahadur G, Whelan J, Ralph D, et al. Gaining consent to freeze spermatozoa from adolescents with cancer: legal, ethical and practical aspects. Hum Reprod 2001;16:188-193.

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  Conflict of Interest:
  None declared.

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