1 Civil Hospital Karachi, Karachi, Pakistan.
2 Department of Pathology and Laboratory Medicine/Oncology, Aga Khan University, Karachi, Pakistan.
J Adolesc Young Adult Oncol. 2019 Feb;8(1):54-60. doi: 10.1089/jayao.2018.0079. Epub 2018 Sep 25.
Cancer survivor rates have increased over the past few decades leading to a growing interest in research related to quality of life (QoL). We attempted to explore the unique barriers that might prevent adult male cancer patients from accessing sperm cryopreservation in Pakistan.
Semi-structured interviews of male cancer patients aged 18-45 years were audio-recorded in Urdu and translated to English and were transcribed ad verbatim. The topics included information regarding risk of infertility following chemotherapy, future reproductive choices, and barriers to sperm cryopreservation. Questionnaire to physicians containing four content domains of knowledge, attitude, practice, and barriers to sperm banking was also delivered. Data were entered and analyzed on SPSS.
Of the 25 patients interviewed, there were 10 cases of leukemia, 3 cases of lymphoma, 2 cases each of colorectal carcinoma and multiple myeloma, 1 case each of neuroblastoma and osteosarcoma, and solitary cases involving the lung, breast, thymus, brain, jaw, and testis. Four patients knew about the risk of infertility. All patients were aware of the option of sperm cryopreservation. Two patients had their sperm preserved before the initiation of chemotherapy. Perceived treatment-related expenses appeared to be the major barrier to sperm cryopreservation in nine patients. This was followed by lack of information, which was cited by eight patients, and religious reasons (n = 2 patients). Other barriers were female gender of the doctor and patient's preferences. Four patients stated no barriers. Nine physicians responded to the questionnaire. Seventy-eight percent of physicians agreed that cancer treatment increases the risk of infertility. 33.3% strongly agreed and 55.6% agreed that infertility can have an adverse impact on QoL.
There is a significant lack of awareness among male cancer patients regarding infertility following cancer treatment. It is imperative that physicians inform them of this and discuss treatment options, along with addressing potential barriers.
在过去几十年中，癌症患者的存活率有所提高，因此人们对与生活质量（QoL）相关的研究产生了浓厚的兴趣。我们试图探讨可能阻止成年男性癌症患者在巴基斯坦获得精子冷冻保存的独特障碍。
对年龄在 18-45 岁之间的男性癌症患者进行了半结构式访谈，以乌尔都语进行录音，并翻译成英语并逐字记录。主题包括化疗后不孕的风险信息、未来的生殖选择以及精子冷冻保存的障碍。还向医生提供了一份包含知识、态度、实践和精子储存障碍四个内容领域的问卷。数据在 SPSS 中输入和分析。
在接受采访的 25 名患者中，有 10 例白血病，3 例淋巴瘤，2 例结直肠癌和多发性骨髓瘤，1 例神经母细胞瘤和骨肉瘤，以及单独涉及肺，乳房，胸腺，脑，颌骨和睾丸的病例。四名患者了解不孕的风险。所有患者都知道精子冷冻保存的选择。两名患者在开始化疗前保存了精子。九名患者认为与治疗相关的费用是精子冷冻保存的主要障碍。其次是缺乏信息，有八名患者提到了这一点，还有两名患者提到了宗教原因。其他障碍包括医生和患者的性别为女性以及患者的个人喜好。四名患者表示没有障碍。九位医生对问卷做出了回应。78％的医生认为癌症治疗会增加不孕的风险。33.3％强烈同意，55.6％同意不孕会对生活质量产生不利影响。
男性癌症患者对癌症治疗后不孕的认识严重不足。医生必须告知他们这一点，并讨论治疗选择，同时解决潜在的障碍。
