The legacy of sperm banking: how fertility monitoring and disposal of sperm are linked with views of cancer treatment.

BACKGROUND Sperm banking is recommended for all men before cancer treatment, which carries a risk of long-term gonadal damage. However, relatively few men take up the offer. Among them, few attend for fertility monitoring or agree to sperm disposal where fertility recovers. Sperm banks are therefore burdened by long-term storage of samples that may not be needed for conception, with implications for healthcare resources. The aims here were to determine the views of men regarding personal benefits of sperm banking, and the advantages and disadvantages of fertility monitoring and disposal in the longer term. METHODS Semi-structured interviews were conducted with 19 men who were diagnosed with cancer and had banked sperm at least 5 years previously. Men were asked to recall their experiences from diagnosis to the present time, focusing on the consequences for their fertility. Interviews were transcribed and analysed using Interpretative Phenomenological Analysis. RESULTS Results are discussed in relation to decisions surrounding banking sperm, fertility monitoring and attitudes to disposal of banked sperm. Complex attitudes were identified, with men's views reflecting their understanding of their current and future fertility and the possible trajectory of cancer itself. Men are overwhelmed by information on diagnosis and fail to understand the implications of cancer treatment for their future fertility. CONCLUSIONS On diagnosis, men are given large amounts of information about cancer and treatment but fail to understand the longer-term implications of sperm banking. These implications need to be specifically addressed at subsequent appointments in order to optimize fertility monitoring and timely disposal of sperm samples.