#205 : Pre-Orchidectomy Fertility Preservation in a Regional Queensland Centre - Patient Attitudes to Sperm Banking

Abstract

Background and Aims: Fertility preservation for testicular cancer remains an essential part of the pre-operative radical orchidectomy discussion. In Australia, testicular cancer is estimated to account for 1.1% of all new male cancer diagnoses, with greater than 800 new cases a year diagnosed in Australia. Toowoomba Hospital and its urology service covers a large geographical area, extending from Toowoomba to the northern territory border. This poses both an access issue for both urological review and subsequent fertility interventions. Despite geographical barriers, pre-operative sperm banking (cryopreservation) remains generally recommended prior to operative intervention. The aim of this study was to investigate adherence to guidelines and identification of barriers or reasons for patients not wanting to engage with fertility preservation. Method: A retrospective analysis of patients undergoing a radical inguinal orchidectomy for the purposes of testicular cancer. Patient records were examined for discussion of fertility preservation and patient outcomes for attending a fertility-consultation. Results: Between 2016-2022, 54 patients underwent a radical orchidectomy at the Toowoomba Hospital. All patients pre-operatively had discussion surrounding fertility preservation and where patient accepted, referrals were made to the closest fertility provider. The majority of patients who refused pre-operative sperm banking had clear reasoning including completion of family. Conclusion: Fertility preservation discussions were part of all interactions pre-operatively where appropriate. Patient reasoning for declining preservation services were varied.