What factors should I consider when counseling my male adolescent patients regarding sperm banking before starting cancer treatment?
If your patient is to receive treatment that can impair fertility, the patient is sexually mature (at least 12 years old and at Tanner stage 3 or higher), and treatment can be delayed to allow for sperm collection, sperm banking should begin as soon as possible. Offer the opportunity for both parents and the patient to ask questions about the process. Sometimes having separate sessions with the patient and parent can decrease anxiety. Remember to consider the financial component associated with collection and storage of the sperm. Typically there is an initial consulting fee and a yearly storage fee. Is it covered by your patient’s insurance? Are there outside resources that can help defray or help assist the family with costs?
If the patient decides to bank sperm, explain that if he is not able to collect sperm, this is not a failure. Given circumstances that may include pain, lack of privacy, and anxiety and stress related to his new diagnosis, collection may be difficult. Try to avoid procedures that require sedation around collection times, and allow for as much privacy as possible. The following Web sites can assist you and your patient: www.fertilehope.org; www.asrm.org; www.ihr.com/oregon/lab/process.htm; and www.cryolab.com. — Karen MacDonald, RN, BSN, CPON
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