Language

English

Publication Date

12-1-2025

Journal

The Oncologist

DOI

10.1093/oncolo/oyaf280

PMID

41138163

PMCID

PMC12715303

PubMedCentral® Posted Date

10-25-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Sperm cryopreservation offers male cancer patients a critical opportunity to preserve fertility prior to gonadotoxic therapy, yet utilization of banked sperm remains modest, typically under 10%. A structured understanding of barriers across the cancer survivorship continuum is needed to support patients in utilization of cryopreserved sperm in alignment with their reproductive goals.

Materials and methods: This expert review synthesizes current evidence and clinical experience to explore the multifaceted barriers to cryopreserved sperm use and propose specific solutions. Key intervention timepoints are examined, including the post-treatment fertility return visit, long-term cryopreservation while remote from family building, readiness for family building, and posthumous considerations. We subsequently outline an optimal Oncofertility Patient Care Pathway.

Results: Multiple clinical, psychosocial, and financial obstacles limit the transition from sperm banking to use. Approximately one-third of survivors do not attend post-treatment fertility return visits, reducing opportunities for counseling and longitudinal reproductive planning. Psychological factors-including fear of cancer recurrence and delayed readiness for family building-contribute to prolonged storage. Many patients remain underinformed about the efficacy and processes of assisted reproductive techniques, while financial concerns are significant. These intersecting barriers hinder use of cryopreserved sperm. Opportunities exist to intervene at key timepoints, as outlined in the Oncofertillity Patient Care Pathway.

Conclusion: A multidisciplinary and structured oncofertility pathway, such as detailed in this review, is needed to support cancer survivors in achieving their reproductive goals. Enhanced counseling, technology-enabled follow-up systems, targeted psychological support, and policies promoting broader insurance coverage for assisted reproduction represent key strategies to overcome existing barriers.

Keywords

Humans, Male, Cryopreservation, Cancer Survivors, Fertility Preservation, Semen Preservation, Spermatozoa, Neoplasms, Sperm Banks, oncofertility, fertility preservation, sperm cryopreservation, sperm banking, male infertility

Published Open-Access

yes

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