Final results of the survey for preservation of adolescent reproduction (SPARE) study: semen preservation knowledge, attitudes, practices and barriers

Abstract

OBJECTIVE: The SPARE survey was designed to obtain robust data on current fertility preservation (FP) knowledge and utilization amongst adolescent oncology health care providers. We describe a subset of the final data that specifically addresses semen preservation knowledge, attitudes, practices, and barriers. DESIGN: A questionnaire based, cross-sectional study assessing adolescent pediatric health care provider attitudes and practices regarding fertility preservation. MATERIALS AND METHODS: The SPARE survey was created by our group and consists of 22 questions (61 total items) assessing FP attitudes and practice patterns for adolescent cancer patients. It includes 19 items specifically dealing with semen preservation knowledge, attitudes, practices, and barriers. The survey was constructed and collected through the use of SurveyMonkey™ and launched via a pediatric oncologist email list serve. Data was analyzed using Microsoft Excel software. RESULTS: Data from 209 respondents including 181 pediatric oncologists has been obtained. 85% of respondents offered sperm banking to pubertal patients most commonly within 1 week of diagnosis. The youngest age at which patients are offered sperm banking was 13 years (median). Estimated cost for the first year of cryo-preserving sperm ranged from $100 to $500,000, with a mean and median of $4547 and $500 respectively. In the event of patient's death, 46% recommend that banked sperm be thawed and destroyed, 37% recommend it be given to parents, and 23% recommend donating the sperm to a research facility. The most likely reason for physicians to not recommend sperm banking was a patient having a poor survival prognosis or an aggressive disease requiring immediate initiation of treatment, with the second most likely reason being lack of parental consent; physician discomfort in discussing sperm banking was not reported as a risk factor. The most commonly reported reason that pubertal male patients or parents refused sperm banking prior to treatment was a desire to initiate treatment as soon as possible and they did not want to be concerned with possible infertility. CONCLUSIONS: Pediatric oncologists are strongly motivated to preserve fertility in male pediatric cancer patients through semen preservation but barriers exist. Additional utilization of semen preservation techniques and promotion of the ASCOR are essential to optimize reproductive health of young cancer patients.