Identifying potential barriers to sperm cryopreservation among Pakistani male cancer patients

Document Type



Pathology and Laboratory Medicine


Background: Cancer survivor rates have increased over the past few decades leading to a growing interest in research related to quality of life. The American society of clinical oncology’s updated guidelines of 2013 recommend that health care providers discuss the possibility of infertility with patients and present fertility preservation options to those who express interest. We attempted to explore the unique barriers that might prevent adult male cancer patients from accessing sperm cryopreservation in Pakistan.
Methods: We conducted semi-structured interviews of male cancer patients aged 18-45 years, diagnosed with cancer of any stage or type. The interviews were audio-recorded in Urdu and translated to English, following which they were transcribed ad verbatim. The topics included quality of information received regarding the risk of infertility following chemotherapy, future reproductive choices and barriers to sperm cryopreservation.
Results: Out of the 25 patients interviewed, there were n = 10 cases of Leukemia, n = 3 of Lymphoma, n = 2 cases each of colorectal carcinoma and Multiple Myeloma, n = 1 case each of Neuroblastoma and Osteosarcoma, and solitary cases involving the lung, breast, thymus, brain, jaw and testis. Only n = 4 patients knew about the potential for infertility due to cancer chemotherapy, all of whom were also aware of the option of sperm cryopreservation. Two patients had their sperm preserved prior to the initiation of chemotherapy. Perceived treatment related expenses appeared to be the biggest barrier to sperm cryopreservation for n = 9 patients (36%). This was followed by lack of information which was cited by n = 8 patients (32%) and religious reasons (n = 2 patients, 8.3%). Other barriers were identified as family wishes, female gender of the doctor and patient’s preferences. Four patients stated there are no barriers.
Conclusions: There is a significant lack of awareness among male cancer patients regarding threat to fertility following cancer treatment. It is imperative that physicians inform them of this and discuss treatment options, along with addressing potential barriers.

Publication (Name of Journal)

Journal of Clinical Oncology