Efficacy of standardized nursing fertility counseling on sperm banking rates in cancer patients

Chemotherapy often damages spermatogenesis, leading to transient or permanent infertility. However, many clinicians fail to consistently incorporate fertility preservation prior to treatment. The current study examines sperm banking amongst patients undergoing formalized fertility counseling prior to initiating chemotherapy. A retrospective chart review was performed for two institutions in Providence, RI. Men aged 18-50 with newly diagnosed cancer, from 1998 to 2003, prior to initiation of chemotherapy were evaluated. A standardized nursing education session including directed fertility counseling was implemented at one of the institutions in 2007. Patient characteristics including age, cancer type, chemotherapy and/or radiation regimen, marital status, offspring status, desire for information on sperm banking were recorded. Records of the area’s only sperm bank were reviewed. Using bivariate statistical analysis, rates of sperm banking amongst patients who received counseling were compared to those without counseling at institution A. Multiple logistic regression was used to model the relationship between time, offspring status and age at both institutions. 775 male patients were identified with a mean age of 40.98 years old. The most common cancer type treated was lymph node (19.3%). At the time of diagnosis, 59.7% of patients already had children, 55.4% were married, 30.6% were single and 7.5% were divorced. Of the 775 patients studied, 411 (53%) were treated at institution A and of those 90 (23.4%) received fertility counseling. Of those who received counseling 15 (16.67%) underwent sperm banking compared to 20 (6.2%) of the 321 who did not receive counseling. This represented a significant increase in sperm banking rates (p<0.01). The odds of sperm banking increased over time at both institutions (p=.0009) but the odds of sperm banking increased 2.3 times more at institution A relative to institution B (p=.0073). The odds of sperm banking increased 4.9 times more for those who did not have children relative to those who did (p<.0001). Finally, for every year increase in age, the odds of banking decreased by 15% (p<.0001) The rates of sperm banking amongst cancer patients increased with the receipt of a formalized nurse counseling session prior to initiation of chemotherapy. These findings may validate the use of a formalized fertility counseling for patients prior to initiation of chemotherapy.