Reproductive issues for men with cancer: technology and nursing management

To review the current medical technologies available to protect the reproductive potential of adult males undergoing sterilizing cancer treatments; to describe the attributes and limitations of these technologies and how oncology nurses can access them for the patient; and to discuss psychosocial elements, including the legal considerations of oncology nurses who counsel patients.

Quantitative data from personal clinical records; personal clinical experience; published articles, abstracts, and books identified by bibliographic data base searches; and consultation with lawyers.

Cancer treatment can have severe and adverse long-term iatrogenic effects on male fertility. Medical technologies that protect male reproduction potential from sterilizing procedures have progressed from unreliable to clinically practical over a period of 20 years. The present clinical means for preserving the potential reproductive capacity of men at risk is cryopreservation of sperm before treatment begins, followed by assisted reproductive technology when pregnancy is desired. Medical, legal, and religious issues relevant to counseling are involved.

Current reproductive technology provides realistic hope for future procreation by men facing sterilizing cancer treatment.

Nursing intervention primarily involves providing patient counseling and arranging patient access to cryopreservation facilities. Oncology nurses can assist men making these types of reproductive decisions by assessing their medical and psychological need for information and by counseling them in regard to human sexuality, the fertility risk of oncologic therapy, the availability of reproductive interventions, and the social ramifications of using stored semen.