Language

English

Publication Date

10-25-2025

Journal

The Oncologist

DOI

10.1093/oncolo/oyaf280

PMID

41138163

Abstract

Cryopreservation of sperm offers male cancer patients a critical opportunity to preserve fertility prior to gonadotoxic treatments. Despite its increasing availability, utilization rates remain modest at typically less than ten percent. This expert review provides a framework for an optimal Oncofertility Patient Care Pathway, explores the multifaceted barriers to cryopreserved sperm use, and proposes specific solutions. We focus on key timepoints for intervention, including the post-treatment fertility care return visit, continued sperm cryopreservation while remote from family building, eventual readiness for family building, and posthumous considerations. Patients often face difficulty engaging in post-treatment reproductive follow-up, with one-third of patients missing fertility return visits. Psychological factors such as fear of cancer recurrence and cancer-related delayed readiness for family building contribute to prolonged storage times. Patients are often underinformed regarding the efficacy of assisted reproductive techniques, and financial concerns are significant. We call for a multidisciplinary approach to overcome these barriers, consisting of enhanced patient counseling, technology-driven follow-up systems, targeted psychological support, and policy changes promoting increased insurance coverage of assisted reproduction services. Addressing patient barriers to cryopreserved sperm utilization within the framework of a clear oncofertility pathway is needed to support cancer survivors in achieving their reproductive goals.

Keywords

Oncofertility. fertility preservation. male infertility. sperm banking. sperm cryopreservation

Published Open-Access

yes

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