Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
J Urol. 2012 Mar;187(3):979-86. doi: 10.1016/j.juro.2011.10.154. Epub 2012 Jan 20.
Survival to reproductive age among men with cancer has steadily increased and yet cancer therapy and cancer itself may carry the risk of infertility. Since 2006, we have used a formalized fertility preservation program with expedited fertility care at our institution. We assessed the impact of this program by comparing the frequency of sperm cryopreservation and patient characteristics before and after its implementation.
Men 18 to 55 years old diagnosed with cancer at our institution from 2002 to 2010 were included in our study. We retrospectively reviewed patient charts to identify those who were offered and subsequently used fertility preservation services before and after program formalization.
From 2002 to 2010 at our institution 4,818 men 18 to 55 years old were diagnosed with cancer, of whom 411 were offered fertility preservation consultation and 249 underwent sperm cryopreservation. Since program implementation, the annual number of men receiving fertility preservation consultation and undergoing sperm cryopreservation increased by 2.4 and 2.7-fold, respectively, while the total number diagnosed with cancer remained fairly constant. Upon substratifying patients into the more conventional reproductive age range of 18 to 40 years 23.4% of all men with cancer in this group were offered consultation before formalization vs 43.3% after formalization (p <0.05). The overall sperm use and discard rates were 8.4% and 14.8%, respectively.
A formalized institutional fertility preservation program significantly increased the overall number and percent of male patients with cancer who received fertility preservation consultation and pursued sperm cryopreservation. These increases were seen in men with all types of cancer and across all demographics assessed at our institution.
癌症患者存活至生育年龄的比例稳步上升，但癌症治疗和癌症本身可能会带来不孕风险。自 2006 年以来，我们在机构中使用了一个规范化的生育力保护计划，并加速了生育力护理。我们通过比较该计划实施前后精子冷冻保存的频率和患者特征来评估该计划的影响。
我们的研究纳入了 2002 年至 2010 年在我院诊断为癌症的 18 至 55 岁男性患者。我们回顾性地查阅了患者病历，以确定在计划规范化前后提供并随后使用生育力保护服务的患者。
2002 年至 2010 年，我院共有 4818 名 18 至 55 岁的男性被诊断为癌症，其中 411 名接受了生育力保护咨询，249 名接受了精子冷冻保存。自计划实施以来，接受生育力保护咨询和进行精子冷冻保存的男性人数每年分别增加了 2.4 倍和 2.7 倍，而癌症总诊断人数保持相对稳定。将患者细分为更传统的生育年龄范围 18 至 40 岁，在这一年龄组中，有癌症的所有男性中有 23.4%在规范化前接受了咨询，而规范化后有 43.3%（p<0.05）。总的精子使用和丢弃率分别为 8.4%和 14.8%。
一个规范化的机构生育力保护计划显著增加了接受生育力保护咨询和进行精子冷冻保存的癌症男性患者的总数和比例。这些增加见于我们机构评估的所有类型癌症和所有人群。
