In general all males should be counseled for sperm cryopreservation prior to initiating therapy. The exceptions are prepubescent males and older males whose spouse is postmenopausal. Unfortunately many men are not informed about the option prior to starting cancer treatment.
Tumors typically affecting candidates for sperm cryopreservation:
(1) Hodgkin's disease
(2) testicular cancer
(3) leukemia
(4) non-Hodgkin's malignant lymphoma
Reasons why a patient may decide not to store sperm:
(1) no additional children wanted (family complete)
(2) moral objection
(3) unable or unwilling to bear the expense
(4) overwhelmed by the cancer diagnosis
(5) unwilling to delay cancer treatment for sperm donation (in practice the delay need only be a few days)
(6) embarrassed to go to a sperm bank
A person who may regret not having stored sperm:
(1) young single male without offspring
(2) male who wants additional children
(3) male with a wife who wants additional children
The semen should be analyzed prior to storage. The presence of poor pre-freeze function is associated with poor post-freeze quality. With modern in vitro techniques it is possible to fertilize an egg even with poor specimens, but care should be taken to (1) use an appropriate method and (2) collect multiple semen specimens.
