Conversation Prompts for Discussion of Male Fertility Preservation

Parent to Medical Provider

The first set of questions is intended for parents to get fundamental  information from their medical provider.  PORF uses the term “medical provider,” because medical practices vary in how they interface with parents and patients. Sometimes the nurse practitioner, or physician assistant is a more comfortable source of information than the primary physician.  Some practices have a special representative who addresses issues of fertility preservation.  It is most important that parents speak to someone who is knowledgeable and a good listener.

Post-pubertal Questions:

  1. Do you have evidence that our son’s fertility has been compromised by the cancer itself?
  2. If so, do you believe there will be enough sperm for successful cryo-preservation?
  3. How will the sperm be collected?
  4. Will one sperm collection be sufficient for cryo-preservation?
  5. How difficult is it to make use of the preserved sperm?
  6. In the event of a pregnancy, is there any reason to believe the cancer, or the cancer treatment could endanger the fetus?

Pre-pubertal Questions:

  1. Do you have evidence that our son’s fertility has been compromised by the cancer itself?
  2. If so, is he a candidate for testicular tissue harvesting?
  3. Will a tissue harvest cause our son more pain, or delay the start of chemotherapy?
  4. Medical research is notoriously slow, do you believe our son will personally benefit from this procedure in his lifetime?
  5. In the event of a pregnancy, is there any reason to believe the cancer, or the cancer treatment could endanger the fetus?

Parent to Parent

Answers to the questions above will give parents a good basis for their own discussion.  Parents will be able to assess the value of the procedure for their own son.  The age of their son and the promise of research bearing fruit are two important considerations for parents to discuss.

Post-pubertal Questions:

  1. Are we comfortable having a discussion about sperm harvesting with our son?
  2. If not, do we know of someone who would be comfortable having such a conversation?
  3. Does our religion or our culture take issue with sperm harvesting and preservation?
  4. If so, should we consult with a religious consultant before we talk with our son?
  5. Will we be able to afford the cost of storing the sperm?

Pre-pubertal Questions:

  1. Since this research is very new, are we certain that it will not make our son more uncomfortable, or delay his treatment?
  2. Will our insurance pay for the research procedure?
  3. Will we be able to afford the cost of storing the tissue?
  4. Should we discuss this research with a religious consultant?

Parent to Religious Consultant

Post pubertal Questions:

  1. How does our religion view sperm harvest under our circumstances?

Pre-pubertal Questions:

  1. How does our religion view cryo-preservation of testicular tissue?

To be hopeful in a time of tremendous stress is a demonstration of strength.  Parents need support, encouragement, and courage to address the issue of fertility preservation.  However, by its very nature, this is a discussion of hope for the future.  We would not have this hope without the miracle of modern medicine.  Since the vast majority of children with cancer live vibrant, productive lives, a parent’s gift of fertility may be well worth the struggle.