Knowledge and Attitudes Towards Fertility Preservation in Patients Undergoing Radical Prostatectomy

To better understand the fertility discussion experience and attitudes regarding the fertility of men undergoing radical prostatectomy (RP).

Men who had an RP within the prior 3 months who were ≤50 years of age with a partner of reproductive age (≤45 years) were included. In a written questionnaire, men were asked about their understanding of the impact of RP on their future fertility, whether they were counseled on sperm banking, whether they actually banked sperm, and if they had not, their level of interest in sperm extraction post-RP. Patient and partner demographic data was recorded. A multivariable model was constructed to look for predictors of interest in fertility in men undergoing RP.

In total, 364 men responded to the questionnaire. Median patient and partner age were 45 (39,49) and 35 (34,40) years, respectively. Twenty-eight percent of men indicated an interest in future fertility. Fifty-eight percent of men did not recall being told about anejaculation post-RP, 84% were unaware that sperm banking preoperatively was an option, and only 7% of those interested in fertility actually banked sperm. Only 8 men (2%) were aware that testis sperm extraction was a possibility post-RP. Predictors of interest in fertility post-RP included younger partner age, patient without children, and partner without children.

While the majority of men undergoing RP are not interested in fertility, a distinct minority are and appear to be poorly educated and prepared for fertility decisions before or after RP.