Fertility Preservation for Boys Being Treated for Cancer
Shawn: My cousin and I were watching a movie, and the person on TV said something about sperm banking. And I don't know why, but then he just looked at me. I'm like, "Yes, I did that too. It was awkward. I don't want to talk about it much." He's like, "Well, can I ask you a couple questions?" We ended up talking about it for like a half hour. So he was curious. I don't know why, but we talked about it, and I told him never to discuss it again.
Jill Ginsberg, MD: CHOP's fertility program is really the first of its kind in the United States, and what we're proud of is that we're actually able to offer fertility preservation options to boys, pre-pubertal and pubertal, and also girls, pre-pubertal and pubertal. So it's really very comprehensive, and there really isn't another program like this in the country.
Joe Gostomski: When they tell you your son is diagnosed with cancer, it's the last thing on your mind. It's the last thing you'd think about. You'd never, ever consider that this is something you have to do. And, you know, when I talked to Adam first about it, although he may not remember it, you know, his first reaction was, "Don't worry, I don't know if I'm going to ever have kids. I don't know if I want kids." You know, that's from his 15-year-old mind. But I was concerned. I would like some grandchildren eventually.
Sue Ogle, RN: Part of what our job is is to make them feel comfortable, to let them know why this is important, and to sort of set the scene, really quickly. We usually have about 30 seconds to develop that relationship, and you have to do it in a way that feels right for each teen and their parents.
Demetria Hamilton: At first, I was, like, a little taken aback. But then, you know, I did my research, and I felt like if I'm going to trust them in taking care of my son, then I need to trust them in this area, too. Because I feel like that's what they're doing. They're just looking at his future, his best interest. He's going through all this, but 10 years from now, 20 years from now, he might want to have a family. And because I was naïve or, you know, close-minded in something that I might not have felt comfortable with, it really doesn't matter. It's my son and his future.
Jill Ginsberg, MD: It's really important for our patients to sperm bank at diagnosis, before they've received any treatment, because even a little bit of treatment can affect the sperm count. So we really try and have the patient make their decision at diagnosis and then do the sperm banking as quickly as possible so then we can start treatment.
Larry: It's not painful at all. They take great care of you. You don't have to worry about anything when you go in there. I had not a fun time, but it was a comfortable time. And they'll make sure that you're comfortable with the whole process, and they'll ask questions that you're not sure you want talked about, but you should. You should do it, because you never know if you want to have kids or not. You're young, so you never really decide until you get older.
Alex: I've always wanted to, you know, have a family of some kind, and it was just, you know--it was a very easy decision for me to just say, "Yes, I definitely want to have that option."
Shawn: The process was really quick. You went there. You sat there for like 15 minutes, filled out a little bit of paperwork. They took you back, you did what you had to do, you came back, you left.
Jill Ginsberg, MD: You know, the goal of chemotherapy is to actually kill rapidly dividing cells. Unfortunately, the sperm or the sperm producing cells are rapidly dividing. So chemotherapy can target those cells and, you know, destroy them. And so that's how boys can become infertile from their chemotherapy.
Shawn: It didn't occur to me that one of the possibilities would be infertility. She was really cool about it, but, like, just the first thought of it is like, "Okay, you want me to do what, exactly?" I mean, it took me by surprise. But, like, in the long run, I'm really, really happy I did it now.
Sue Ogle, RN: We acknowledge up front that this is a really embarrassing topic to discuss, and one thing that we try to assure all of our boys is that when we see them again — we will see them in clinic, we'll see them in the halls, we'll see them wherever they are — we won't be yelling across the waiting room or whatnot, "Hi. How are you? Do you remember me from sperm banking?"
Adam: Kids my age and younger should know that it's a completely normal process, and it doesn't make you weird or anything. It's good to have it in the back pocket in case I do change my mind.
Sue Ogle, RN: Approximately 85 percent of the boys that we approach do go on and sperm bank, and I think a lot of this really has to do with how we begin the discussion, how we continue it, and also the hope we bring.
Mark Dority: I want him to have everything he wants to have. He has expressed that he wanted to have kids even before, you know, this had occurred. So, you know, I think that's part of my job, is to help him get to wherever it is that he's trying to get to.
Jill Ginsberg, MD: They're dealing with a lot of information at diagnosis, you know, what treatment protocol they're going to go on. And then when we approach them about this sperm banking, it sometimes can feel overwhelming. But what we've heard mostly from our patients and our families is that it offers them hope, because if people are actually even thinking about this issue or thinking about the need to sperm bank for future fertility, they must really think things are going to be okay.
Shane: I think that helped me out a lot, now that I think about it. Because, in my eyes, I was like it — was the end. But on the other hand, if someone's thinking that I can survive, so — if someone thinks I can survive, I should be thinking that, "Yeah, I can survive." And so, like, them coming to me and asking me about sperm bank, I think that really helped because that gave a positive thought in my mind, a positive idea.
Shawn: I cannot put into words how happy I am that I made this decision, just the whole knowing that, like, I have that option now, even if I'm not fertile. It's just really relaxing to know that, like, if I can't do it myself, then my little guys can.
Topics Covered: Fertility Preservation Program
Related Centers and Programs: Childhood Cancer Survivorship Program, Cancer Center, Bone and Soft Tissue Tumor Program, Solid Tumor Program, Pediatric Neuro-Oncology Program, Relapsed Leukemia and Lymphoma Program, Leukemia and Lymphoma Program