Publication:

Exploring and investigating the long-term ramifications of fertility preservation in men with a history of cancer: a 10-year retrospective follow-up study

Background Cancer treatments such as chemotherapy, radiotherapy, and surgery can adversely affect male fertility, leading to temporary or permanent sterility. Sperm cryopreservation is the standard fertility preservation strategy for young male cancer patients prior to gonadotoxic therapy. However, utilization rates of stored samples remain low despite increased awareness and accessibility.

Methods This retrospective study analyzed data from 136 male cancer patients who underwent sperm cryopreservation at Madras Medical Mission Hospital, Chennai, over a 10-year period. Patient records were reviewed to assess return rates for assisted reproduction, post-treatment semen analysis outcomes, and psychosocial factors influencing fertility-related decisions.

Results None of the patients who banked sperm returned for assisted reproductive procedures. Post-treatment semen analysis was available for a subset of patients, among whom 82.9% demonstrated spontaneous recovery of fertility. Psychosocial barriers, including lack of a partner, financial constraints, and diminished reproductive intent, contributed to the non-utilization of cryopreserved sperm.

Conclusion Although sperm cryopreservation offers an effective safeguard against treatment-induced infertility, its utilization remains minimal. The high rate of spontaneous fertility recovery and psychosocial limitations appear to influence decision-making. These findings highlight the need for individualized fertility counselling, systematic follow-up, and strategies to mitigate financial barriers. Integration of fertility preservation into comprehensive cancer survivorship programs is crucial to optimize reproductive outcomes and improve long-term quality of life in male cancer survivors.