A cancer diagnosis is devastating for most patients. The most common response is to focus on getting the right treatment as quickly as possible in order to survive the diagnosis. While this response is completely appropriate, it is our job as physicians to counsel patients about the risk and benefits of lifesaving cancer therapy. As urologists, a major concern is the risk cancer treatment poses to male fertility.
Unfortunately, many patients today report little to no discussion with physicians about the potential effects of cancer treatment on future fertility or fertility preservation options prior to cancer treatment.
Fortunately, many men will not face permanent fertility impairment. While this fact is reassuring, it does not help men who struggle with infertility as a result of cancer treatment and desire paternity later in life.
What Are My Risks?
Calculating an exact risk of infertility following cancer treatment is very complicated and difficult to accurately predict. This is because risk to fertility depends on the type of treatment, duration of treatment, and drug dosage. Certain chemotherapy regimens are higher risk than others and the same applies to radiation and surgery. The bottom line is that for many men, preserving their sperm is an insurance package. Hopefully, they will not need it, but if they do it becomes priceless.
How Do I Preserve My Fertility?
Fertility preservation is usually done through a local sperm bank. Males will typically make an appointment with the local sperm bank to preserve their sperm PRIOR to beginning cancer treatment. They will be given a date and time to collect. It is preferable to collect the specimen on site via self-stimulation when possible. Most patients will need to provide more than one specimen. We routinely recommend freezing sperm PRIOR to most cancer treatments. We do NOT recommend freezing sperm after starting chemotherapy as these sperm have been exposed to chemotherapy and this could potential place offspring at unnecessary risk.
Should I Freeze Sperm Prior to my Appointment?
We generally recommend that patients try to freeze 2 samples prior to treatment, even if you haven’t seen us in the clinic for counseling. This will ensure there are enough sperm available for multiple options if needed in the future.
If you are not comfortable freezing sperm prior to seeing us, that is ok! We will do our best to get you seen as soon as possible before sperm cryopreservation (sperm freezing) if desired.
We recommend that patients contact E and A Labs (see contact information below) here in Shreveport ASAP. We do NOT recommend freezing sperm after a patient has started chemotherapy.
Please keep in mind that we may or may not have the official sperm cryopreservation report to discuss in clinic depending on the time frame as everything is moving very quickly because we want to ensure you receive cancer therapy as soon as possible.
E and A Labs
2401 Greenwood Road Suite B
Shreveport, LA 71103
What Are the Costs?
Unfortunately, fertility preservation (freezing sperm) is generally not covered by insurance at this point in time. Pricing, however, is very competitive and these cost are for the lab only, not Regional Urology.
Pricing per specimen is $320. This includes the cost to process, freeze, required infectious disease blood tests, and storage for 6 months. Storage fees after the first 6 months will then take effect. Storage costs after the first 6 months are approximately $320/year (or about $25/month). Cost issues must be discussed with E and A Labs as Regional Urology does not control these costs.
Keep in mind that if financial assistance is needed, the patient may need to use a mail order collection kit rather than the local lab, E and A labs in Shreveport.
Below is a link to Reprotech, which is a company that also processes and stores sperm long term. They have the ability to mail collection kits overnight. The specimen is then collected at home and mailed back to the facility. Patients may or may not qualify for financial assistance with this company. Please look into this as soon as possible if you think you may need help.
Regional Urology is happy with help guide patients and counsel patients about fertility preservation options, but does NOT control pricing.
Financial Assistance Link: Reprotech
What If My Fertility Does Not Return?
Fertility options after cancer therapy depend on a variety of factors. Namely, the quantity and quality of the sperm present in the ejaculate will determine if insemination (IUI) is an option rather than only in vitro fertilization (IVF). We will not be able to appropriately counsel on these options until specimens are provided and processed by the lab.
How Long Can Sperm Be Frozen?
Several reports have shown that frozen sperm may be used 20-30 years later with excellent results.
When Can We Start Trying for a Pregnancy?
We advise most couples to have protected sex for at least 1 year after finishing chemotherapy. At this time, most experts feel that the risk of having a child with genetic defects returns to baseline or pre-treatment levels after one year.
We like to see men for a follow up visit 6 months after finishing treatment for hormone levels and semen parameters.