Distance From Fertility Center Affects Use of Fertility Preservation by Male Patients With Cancer

Male patients with cancer who are referred for fertility preservation (FP) are more likely to undergo sperm cryopreservation when they are closer to the FP clinic, according to research published in JCO Oncology Practice. 

Researchers found that increased distance from a FP clinic was associated with a decreased chance of semen sample submission by men undergoing gonadotropic chemotherapy. 

This retrospective cohort study included 461 patients who were referred to a FP center between 2013 and 2021. The mean age of the patients was 25.8±8.9 years (range, 12 to 64 years).

Of the 461 patients, 326 (71%) provided at least 1 semen sample after referral and 198 (43%) provided at least 2 samples. One hundred and thirty-five patients (30%) did not submit a sample. 

According to the researchers, greater distance from their fertility preservation center was associated with lower odds of submitting a semen sample (odds ratio [OR], 0.85; 95% CI, 0.75-0.97; P <.05).

Of the patients, 54% traveled fewer than 20 miles to reach the fertility center and 7% traveled more than 100 miles. While overall, the percentage of people who provided a sample was consistently high, regardless of distance, the researchers noted that people who traveled less than 20 miles and those who traveled 20 to 40 miles achieved utilization rates of 73.6% and 76.1%, respectively. When patients had to travel 40 to 100 miles, the rate dropped to between 55% and 60%. Of the 9 patients who had to travel more than 200 miles, 7 (77.8%) of them eventually provided a sample. 

Distance seemed to be an impetus for some patients who traveled a greater distance to provide more than 1 sample. A subgroup analysis of the 326 men who provided at least 1 semen sample revealed that a greater distance was associated with a “small but significant” increase in the number of vials of sperm that were cryopreserved (relative risk [RR], 1.04; 95% CI, 1.01-1.06). 

“In conclusion, men referred for FP have a consistently high level of utilization, although those who lived further away from our fertility center were less likely to submit a semen sample after referral,” the researchers wrote. “Hospital systems and fertility providers should understand that this represents a potential barrier to care even after referral to a reproductive specialist.”

The researchers noted that the study population only included referrals to 1 fertility center with a large catchment area, so the findings might not be valid for other centers. Nor did the study account for actual travel time for the participants. 

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Pelzman D, Dederer G, Joolharzadeh P, et al. Effect of distance from fertility center on utilization of fertility preservation referral in men. JCO Oncol Pract. Published online March 16, 2023. doi: 10.1200/OP.22.00789