Journal of cancer survivorship : research and practice · 2025
Perception of infertility risk vs. objective fertility status in males exposed to alkylating agents but not radiation therapy: a report from the St. Jude Lifetime (SJLIFE) cohort study.
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Ware Megan E, We Raymond K, Kutteh William H, Webster Rachel T, Delaney Angela, Yu Christine, Shelton Kyla, Srivastava DeoKumar, Taneja Siddhant, Sapkota Yadav, Wang Zhaoming, Hudson Melissa M, Lucas John, Armstrong Gregory T, Ness Kirsten K, Green Daniel M
Аннотация
PURPOSE: This study aimed to characterize associations between male childhood cancer survivors' perception of infertility risk and objective fertility status and to identify factors contributing to risk perception.
METHODS: Participants were from SJLIFE, exposed to alkylating agents but not radiation, and completed a Men's Health Questionnaire (MHQ) and semen analysis. Samples were obtained following the 2010 World Health Organization Guidelines, and classified as azoospermic (0 sperm), oligospermic (> 0 and < 15 million sperm/ml), or normospermic (≥ 15 million sperm/ml). Participants were classified as at minimally or high/significantly increased risk for infertility according to the Pediatric Initiative Network (PIN) criteria. Perception of infertility risk was assessed via self-report where survivors indicated the following: (1) more risk than peers without cancer history, (2) less risk, or (3) equal risk, as well as factors contextualizing perceived risk. Chi-squared tests or Fishers' exact tests assessed differences in variables of interest.
RESULTS: Among 238 participants (age 27 ± 6 years, 85% NH White, 47% survivors of leukemia), 58% perceived increased infertility risk than peers without cancer history, 29% equal risk, and 13% less risk. A larger proportion of survivors with azoospermia perceived higher risk than other groups (74%) (p = 0.01). No differences were observed in risk perception by PIN criteria. No differences were observed by sperm concentration category or PIN criteria in factors contextualizing perceived risk.
CONCLUSIONS: Male survivors not exposed to radiation in the SJLIFE cohort are generally aware of their infertility risk.
IMPLICATIONS FOR CANCER SURVIVORS: Male survivors should seek continued follow-up care regarding fertility and information on risk from reputable sources.
METHODS: Participants were from SJLIFE, exposed to alkylating agents but not radiation, and completed a Men's Health Questionnaire (MHQ) and semen analysis. Samples were obtained following the 2010 World Health Organization Guidelines, and classified as azoospermic (0 sperm), oligospermic (> 0 and < 15 million sperm/ml), or normospermic (≥ 15 million sperm/ml). Participants were classified as at minimally or high/significantly increased risk for infertility according to the Pediatric Initiative Network (PIN) criteria. Perception of infertility risk was assessed via self-report where survivors indicated the following: (1) more risk than peers without cancer history, (2) less risk, or (3) equal risk, as well as factors contextualizing perceived risk. Chi-squared tests or Fishers' exact tests assessed differences in variables of interest.
RESULTS: Among 238 participants (age 27 ± 6 years, 85% NH White, 47% survivors of leukemia), 58% perceived increased infertility risk than peers without cancer history, 29% equal risk, and 13% less risk. A larger proportion of survivors with azoospermia perceived higher risk than other groups (74%) (p = 0.01). No differences were observed in risk perception by PIN criteria. No differences were observed by sperm concentration category or PIN criteria in factors contextualizing perceived risk.
CONCLUSIONS: Male survivors not exposed to radiation in the SJLIFE cohort are generally aware of their infertility risk.
IMPLICATIONS FOR CANCER SURVIVORS: Male survivors should seek continued follow-up care regarding fertility and information on risk from reputable sources.