Semen collection from young cancer patients

The Annual Meeting of the British Andrology Society held in Bristol in October 2000 included a short symposium of invited speakers to address some of the increasingly difficult dilemmas encountered by doctors who deal with young boys undergoing treatments that are likely to render them sterile. Public awareness in this area is growing and, increasingly, young boys undergoing such treatments, and their parents, are requesting sperm storage. The first speaker at the symposium was Dr Helen Kershaw who works as a clinician in the field of paediatric oncology. She set the scene by explaining the incidence of childhood cancer, the treatments available, survival rates and the urgent time frame in which oncologists must work. Dr Catherine Coulson, who gave the second talk, works as a clinician in the field of reproductive medicine and has experience of counselling boys and their parents before attempting to store sperm. She explained some of the difficulties encountered and raised the question of whether storing sperm was always justified. The third speaker was Dr John Radford who works as an oncologist and has conducted research into the uptake and use of stored sperm. He has researched the possibility of storing germ cells before sterilizing treatment for Hodgkin and non-Hodgkin lymphoma, and injection of the cryopreserved germ cells into the testes after treatment. Dr Victor Larcher, who works as a paediatrician and has an interest in ethics and the law, gave the final talk. He explored some of the ethical issues surrounding sperm storage generally and issues of consent in children in particular. Discussion was lively and raised the question of who should provide counselling in such cases and for how long. The need to provide an urgent service and yet provide information that is easily understandable so that truly informed consent is obtained is clearly taxing those working in the field.