Psychological Impact and Barriers to Fertility Preservation in Male Cancer Patients

  • Angela K. LawsonEmail author


Male cancer patients are increasingly interested in pursuing fertility preservation prior to undergoing gonadotoxic cancer treatments. However many patients do not receive appropriate fertility preservation counseling or referral for fertility preservation treatment. Both patient-specific and institutional barriers have been identified which limit patients’ ability to complete fertility preservation treatment. Many of the identified institutional barriers have the ability to result in disparate fertility preservation counseling. Patients who do not receive appropriate fertility preservation counseling are at risk of future regret, anger, sadness, and other negative psychological outcomes and potentially decreased chances of future genetic family building. For patients who do receive fertility preservation counseling, their current emotional status as well as that of their loved ones related to the patient’s cancer diagnosis may interfere with decision-making ability. Patients who accept or decline fertility preservation treatment may face additional psychological risks. Regardless, all cancer patients who will be exposed to gonadotoxic treatments should receive fertility preservation counseling and referral for additional counseling by a fertility specialist. The psychological complexity of fertility preservation in newly diagnosed cancer patients suggests that the inclusion of counseling from an appropriately trained mental health professional is also warranted.


Fertility preservation Counseling Barrier Disparity Distress Psychological Depression Anxiety 


  1. 1.
    Bujan L, Walschaerts M, Brugnon F, Daudin M, Berthaut I, Auger J, et al. Impact of lymphoma treatments on spermatogenesis and sperm deoxyribonucleic acid: a multicenter prospective study from the CECOS network. Fertil Steril. 2014;102(3):667–74. e3CrossRefPubMedGoogle Scholar
  2. 2.
    Fallat ME, Hutter J, American Academy of Pediatrics Committee on Bioethics, American Academy of Pediatrics Section on Hematology/Oncology; American Academy of Pediatrics Section on Surgery. Preservation of fertility in pediatric and adolescent patients with cancer. Pediatrics. 2008;121(5):e1461–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Moss JL, Choi AW, Fitzgerald Keeter MK, Brannigan RE. Male adolescent fertility preservation. Fertil Steril. 2016;105(2):267–73.CrossRefPubMedGoogle Scholar
  4. 4.
    Dearing C, Breen D, Bradshaw A, Ramsay J, Lindsay K. Trends and usage in a London National Health Service Sperm Bank for cancer patients. Hum Fertil (Camb). 2014;17(4):289–96.CrossRefGoogle Scholar
  5. 5.
    Neal MS, Nagel K, Duckworth J, Bissessar H, Fischer MA, Portwine C, et al. Effectiveness of sperm banking in adolescents and young adults with cancer: a regional experience. Cancer. 2007;110:1125–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Lee SJ, Schover LR, Partridge JH, Patrizio P, Wallace WH, Hagerty K, et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol. 2006;24:2917–31.CrossRefPubMedGoogle Scholar
  7. 7.
    Ethics Committee of American Society for Reproductive M. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. Fertil Steril. 2013;100(5):1224–31.CrossRefGoogle Scholar
  8. 8.
    Vadaparampil S, Quinn G, King L, Wilson C, Nieder M. Barriers to fertility preservation among pediatric oncologists. Patient Educ Couns. 2008;72(3):402–10.CrossRefPubMedGoogle Scholar
  9. 9.
    Quinn GP, Vadaparampil ST. Fertility preservation and adolescent/young adult cancer patients: physician communication challenges. J Adolesc Health. 2009;44(4):394–400.CrossRefPubMedGoogle Scholar
  10. 10.
    Stein DM, Victorson DE, Choy JT, Waimey KE, Pearman TP, Smith K, et al. Fertility preservation preferences and perspectives among adult male survivors of pediatric cancer and their parents. J Adolesc Young Adult Oncol. 2014;3(2):75–82.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Crawshaw MA, Glaser AW, Hale JP, Sloper P. Male and female experiences of having fertility matters raised alongside a cancer diagnosis during the teenage and young adult years. Eur J Cancer Care. 2009;18:381–90.CrossRefGoogle Scholar
  12. 12.
    Gardino SL, Jeruss JS, Woodruff TK. Using decision trees to enhance interdisciplinary team work: the case of oncofertility. J Assist Reprod Genet. 2010;27:227–31.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Yee S, Abrol K, McDonald M, Tonelli M, Liu KE. Addressing oncofertility needs: views of female cancer patietns in fertility preservation. J Psychosoc Oncol. 2012;30:331–46.CrossRefPubMedGoogle Scholar
  14. 14.
    Achille MA, Rosberger Z, Robitaille R, Lebel S, Gouin JP, Bultz BD, et al. Facilitators and obstacles to sperm banking in young men receiving gonadotoxic chemotherapy for cancer: the perspective of survivors and health care professionals. Hum Reprod. 2006;12:3206–16.CrossRefGoogle Scholar
  15. 15.
    Fuchs A, Kashanian JA, Clayman ML, Gosiengfiao Y, Lockart B, Woodruff TK, et al. Pediatric oncology Providers’ attitudes and practice patterns regarding fertility preservation in adolescent male cancer patients. J Pediatr Hematol Oncol. 2016;38(2):118–22.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31(19):2500–10.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Multidisciplinary Working Group convened by the British Fertility Society. A strategy for fertility services for survivors of childhood cancer. Hum Fertil (Camb). 2003;6(2):A1–A39.CrossRefGoogle Scholar
  18. 18.
    Peccatori FA, Azim HA Jr, Orecchia R, Hoekstra HJ, Pavlidis N, Kesic V, et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24(Suppl 6):vi160–70.CrossRefPubMedGoogle Scholar
  19. 19.
    Bann CM, Treiman K, Squiers L, Tzeng J, Nutt S, Arvey S, et al. Cancer Survivors’ use of fertility preservation. J Womens Health (Larchmt). 2015;24(12):1030–7.CrossRefGoogle Scholar
  20. 20.
    Letourneau JM, Ebbel EE, Katz PP, Katz A, Ai WZ, Chien AJ, et al. Pretreatment fertility counseling and fertility preservation improve quality of live in reproductive age women with cancer. Cancer. 2012;118:1710–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Letourneau JM, Smith JF, Ebbel EE, Craig A, Katz PP, Cedars MI, et al. Racial, socioeconomic, and demographic disparities in access to fertility preservation in young women diagnosed with cancer. Cancer. 2012;118(18):4579–88.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Duffy C, Allen S. Medical and psychosocial aspects of fertility after cancer. Cancer J. 2009;15:27–33.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Forman EJ, Anders CK, Behera MA. A nationwide survey of oncologists regarding treatment-related infertility and fertility preservation in female cancer patients. Fertil Steril. 2010;94(5):1652–6.CrossRefPubMedGoogle Scholar
  24. 24.
    Quinn GP, Vadaparampil ST, Lee JH, Jacobsen PB, Bepler G, Lancaster J, et al. Physician referral for fertility preservation in oncology patients: a national study of practice behaviors. J Clin Oncol. 2009;27(35):5952–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Quinn GP, Vadaparampil ST, Gwede CK, Miree C, King LM, Clayton HB, et al. Discussion of fertility preservation with newly diagnosed patients: oncologists’ views. J Cancer Surviv. 2007;1(2):146–55.CrossRefPubMedGoogle Scholar
  26. 26.
    Quinn GP, Vadaparampil ST, Bell-Ellison BA, Gwede CK, Albrecht TL. Patient-physician communication barriers regarding fertility preservation among newly diagnosed cancer patients. Soc Sci Med. 2008;66(3):784–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Forman EJ, Anders CK, Behera MA. Pilot survey of oncologists regarding treatment-related infertility and fertility preservation in female cancer patients. J Reprod Med. 2009;54(4):203–7.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Bastings L, Baysal O, Beerendonk CC, Braat DD, Nelen WL. Referral for fertility preservation counselling in female cancer patients. Hum Reprod. 2014;29(10):2228–37.CrossRefPubMedGoogle Scholar
  29. 29.
    Campbell JE, Assanasen C, Robinson RD, Knudtson JF. Fertility preservation counseling for pediatric and adolescent cancer patients. J Adolesc Young Adult Oncol. 2016;5(1):58–63.CrossRefPubMedGoogle Scholar
  30. 30.
    Armuand GM, Rodriguez-Wallberg KA, Wettergren L, Ahlgren J, Enblad G, Hoglund M, et al. Sex differences in fertility-related information received by young adult cancer survivors. J Clin Oncol. 2012;30(17):2147–53.CrossRefPubMedGoogle Scholar
  31. 31.
    Shnorhavorian M, Harlan LC, Smith AW, Keegan TH, Lynch CF, Prasad PK, et al. Fertility preservation knowledge, counseling, and actions among adolescent and young adult patients with cancer: a population-based study. Cancer. 2015;121(19):3499–506.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Armuand GM, Wettergren L, Rodriguez-Wallberg KA, Lampic C. Women more vulnerable than men when facing risk for treatment-induced infertility: a qualitative study of young adults newly diagnosed with cancer. Acta Oncol. 2015;54(2):243–52.CrossRefPubMedGoogle Scholar
  33. 33.
    Chapple A, Salinas M, Ziebland S, McPherson A, Macfarlane A. Fertility issues: the perceptions and experiences of young men recently diagnosed and treated for cancer. J Adolesc Health. 2007;40:69–75.CrossRefPubMedGoogle Scholar
  34. 34.
    Eiser C, Arden-Close E, Morris K, Pacey AA. The legacy of sperm banking: how fertility monitoring and disposal of sperm are linked with views of cancer treatment. Hum Reprod. 2011;26(10):2791–8.CrossRefPubMedGoogle Scholar
  35. 35.
    Yee S, Fuller-Thomson E, Dwyer C, Greenblatt E, Shapiro H. “Just what the doctor ordered”: factors associated with oncology patients’ decision to bank sperm. Can Urol Assoc J. 2012;6(5):E174–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Eiser C, Merrick H, Arden-Close E, Morris K, Rowe R, Pacey AA. Why don’t some men with banked sperm respond to letters about their stored samples? Hum Fertil (Camb). 2014;17(4):278–84.CrossRefGoogle Scholar
  37. 37.
    Gilbert E, Adams A, Mehanna H, Harrison B, Hartshorne GM. Who should be offered sperm banking for fertility preservation? A survey of UK oncologists and haematologists. Ann Oncol. 2011;22(5):1209–14.CrossRefPubMedGoogle Scholar
  38. 38.
    Schover LR, Brey K, Lichtin A, Lipshultz LI, Jeha S. Oncologists’ attitudes and practices regarding banking sperm before cancer treatment. J Clin Oncol. 2002;20(7):1890–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Kohler TS, Kondapalli LA, Shah A, Chan S, Woodruff TK, Brannigan RE. Results from the survey for preservation of adolescent reproduction (SPARE) study: gender disparity in delivery of fertility preservation message to adolescents with cancer. J Assist Reprod Genet. 2011;28(3):269–77.CrossRefPubMedGoogle Scholar
  40. 40.
    Schover LR, Brey K, Lichtin A, Lipshultz LI, Jeha S. Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. J Clin Oncol. 2002;20(7):1880–9.CrossRefPubMedGoogle Scholar
  41. 41.
    Pacey A, Merrick H, Arden-Close E, Morris K, Rowe R, Stark D, et al. Implications of sperm banking for health-related quality of life up to 1 year after cancer diagnosis. Br J Cancer. 2013;108(5):1004–11.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Sonnenburg DW, Brames MJ, Case-Eads S, Einhorn LH. Utilization of sperm banking and barriers to its use in testicular cancer patients. Support Care Cancer. 2015;23(9):2763–8.CrossRefPubMedGoogle Scholar
  43. 43.
    Klock SC, Zhang JX, Kazer RR. Fertility preservation for female cancer patients: early clinical experience. Fertil Steril. 2010;94:149–55.CrossRefPubMedGoogle Scholar
  44. 44.
    Wyns C, Collienne C, Shenfield F, Robert A, Laurent P, Roegiers L, et al. Fertility preservation in the male pediatric population: factors influencing the decision of parents and children. Hum Reprod. 2015;30(9):2022–30.CrossRefPubMedGoogle Scholar
  45. 45.
    Ginsberg JP, Ogle SK, Tuchman LK, Carlson CA, Reilly MM, Hobbie WL, et al. Sperm banking for adolescent and young adult cancer patients: sperm quality, patient, and parent perspectives. Pediatr Blood Cancer. 2008;50(3):594–8.CrossRefPubMedGoogle Scholar
  46. 46.
    Clancy T. A clinical perspective on ethical arguments around prenatal diagnosis and preimplantation genetic diagnosis for later onset inherited cancer predispositions. Familial Cancer. 2010;9:9–14.CrossRefPubMedGoogle Scholar
  47. 47.
    Quinn G, Vadaparampil S, Wilson C, King L, Choi J, Miree C, et al. Attitudes of high-risk women toward preimplantation genetic diagnosis. Fertil Steril. 2009;91(6):2361–8.CrossRefPubMedGoogle Scholar
  48. 48.
    Zebrack BJ, Casillas J, Nohr L, Adams H, Zeltzer LK. Fertility issues for young adult survivors of childhood cancer. Psychooncology. 2004;13:689–99.CrossRefPubMedGoogle Scholar
  49. 49.
    Missmer SA, Seifer DB, Jain T. Cultural factors contributing to health care disparities among patients with infertility in Midwestern United States. Fertil Steril. 2011;95(6):1943–9.CrossRefPubMedGoogle Scholar
  50. 50.
    Smith JF, Eisenberg ML, Glidden D, Millstein SG, Cedars M, Walsh TJ, et al. Socioeconomic disparities in the use and success of fertility treatments: analysis of data from a prospective cohort in the United States. Fertil Steril. 2011;96(1):95–101.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Daudin M, Rives N, Walschaerts M, Drouineaud V, Szerman E, Koscinski I, et al. Sperm cryopreservation in adolescents and young adults with cancer: results of the French national sperm banking network (CECOS). Fertil Steril. 2015;103(2):478–86. e1CrossRefPubMedGoogle Scholar
  52. 52.
    Edge B, Holmes D, Makin G. Sperm banking in adolescent cancer patients. Arch Dis Child. 2006;91(2):149–52.CrossRefPubMedGoogle Scholar
  53. 53.
    Sheth KR, Sharma V, Helfand BT, Cashy J, Smith K, Hedges JC, et al. Improved fertility preservation care for male patients with cancer after establishment of formalized oncofertility program. J Urol. 2012;187(3):979–86.CrossRefPubMedGoogle Scholar
  54. 54.
    Rieker PP, Fitzgerald EM, Kalish LA. Adaptive behavioral responses to potential infertility among survivors of testis cancer. J Clin Oncol. 1990;8(2):347–55.CrossRefPubMedGoogle Scholar
  55. 55.
    Salonia A, Capogrosso P, Castiglione F, Russo A, Gallina A, Ferrari M, et al. Sperm banking is of key importance in patients with prostate cancer. Fertil Steril. 2013;100(2):367–72. e1CrossRefPubMedGoogle Scholar
  56. 56.
    Coccia PF, Pappo AS, Altman J, Bhatia S, Borinstein SC, Flynn J, et al. Adolescent and young adult oncology, version 2.2014. J Natl Compr Canc Netw. 2014;12(1):21–32. quizCrossRefPubMedGoogle Scholar
  57. 57.
    Zapzalka DM, Redmon JB, Pryor JL. A survey of oncologists regarding sperm cryopreservation and assisted reproductive techniques for male cancer patients. Cancer. 1999;86(9):1812–7.CrossRefPubMedGoogle Scholar
  58. 58.
    T’Sjoen G, Van Caenegem E, Wierckx K. Transgenderism and reproduction. Curr Opin Endocrinol Diabetes Obes. 2013;20(6):575–9.CrossRefPubMedGoogle Scholar
  59. 59.
    Wierckx K, Stuyver I, Weyers S, Hamada A, Agarwal A, De Sutter P, et al. Sperm freezing in transsexual women. Arch Sex Behav. 2012;41(5):1069–71.CrossRefPubMedGoogle Scholar
  60. 60.
    De Sutter P, Kira K, Verschoor A, Hotimsky A. The desire to have children and the preservation of fertility in transsexual women: a survey. Int J Transgend. 2002;6(3):215–21.Google Scholar
  61. 61.
    White T, Ettner R. Adaptation and adjustment in children of transsexual parents. Eur Child Adolesc Psychiatry. 2007;16(4):215–21.CrossRefPubMedGoogle Scholar
  62. 62.
    Green D, Galvin H, Horne B. The psycho-social impact of infertility on young male cancer survivors: a qualitative investigation. Psychooncology. 2003;12(2):141–52.CrossRefPubMedGoogle Scholar
  63. 63.
    Saito K, Suzuki K, Iwasaki A, Yumura Y, Kubota Y. Sperm cryopreservation before cancer chemotherapy helps in the emotional battle against cancer. Cancer. 2005;104(3):521–4.CrossRefPubMedGoogle Scholar
  64. 64.
    Quinn GP, Vadaparampil ST, Jacobsen PB, Knapp C, Keefe DL, Bell GE, et al. Frozen hope: fertility preservation for women with cancer. J Midwifery Womens Health. 2010;55:175–80.CrossRefPubMedGoogle Scholar
  65. 65.
    Madrigrano A, Westphal L, Wapnir I. Egg retrieval with cryopreservation does not delay breast cancer treatment. Am J Surg. 2007;194:477–81.CrossRefPubMedGoogle Scholar
  66. 66.
    Wortel RC, Ghidey Alemayehu W, Incrocci L. Orchiectomy and radiotherapy for stage I-II testicular seminoma: a prospective evaluation of short-term effects on body image and sexual function. J Sex Med. 2015;12(1):210–8.CrossRefPubMedGoogle Scholar
  67. 67.
    Rossen P, Pedersen AF, Zachariae R, von der Maase H. Sexuality and body image in long-term survivors of testicular cancer. Eur J Cancer. 2012;48(4):571–8.CrossRefPubMedGoogle Scholar
  68. 68.
    Nilsson J, Jervaeus A, Lampic C, Eriksson LE, Widmark C, Armuand GM, et al. ‘Will I be able to have a baby?’ results from online focus group discussions with childhood cancer survivors in Sweden. Hum Reprod. 2014;29(12):2704–11.CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    Stinson JN, Jibb LA, Greenberg M, Barrera M, Luca S, White ME, et al. A qualitative study of the impact of cancer on romantic relationships, sexual relationships, and fertility: perspectives of Canadian adolescents and parents during and after treatment. J Adolesc Young Adult Oncol. 2015;4(2):84–90.CrossRefPubMedGoogle Scholar
  70. 70.
    Al-Azri M, Al-Awisi H, Al-Moundhri M. Coping with a diagnosis of breast cancer-literature review and implications for developing countries. Breast J. 2009;15:615–22.CrossRefPubMedGoogle Scholar
  71. 71.
    Trask PC, Paterson A, Riba M, Brines B, Griffith K, Parker P, et al. Assessment of psychological distress in prospective bone marrow transplant patients. Bone Marrow Transplant. 2002;29:917–25.CrossRefPubMedGoogle Scholar
  72. 72.
    Montazeri A. Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008;27:32.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Brintzenhofe-Szoc KM, Levin TT, Li Y, Kissane DW, Zabora JR. Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics. 2009;50(4):383–91.CrossRefPubMedGoogle Scholar
  74. 74.
    Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology. 2001;10(1):19–28.CrossRefPubMedGoogle Scholar
  75. 75.
    Carlson LE, Angen M, Cullum J, Goodey E, Koopmans J, Lamont L, et al. High levels of untreated distress and fatigue in cancer patients. Br J Cancer. 2004;90(12):2297–304.PubMedPubMedCentralGoogle Scholar
  76. 76.
    Skaali T, Fossa SD, Andersson S, Langberg CW, Lehne G, Dahl AA. Is psychological distress in men recently diagnosed with testicular cancer associated with their neuropsychological test performance? Psychooncology. 2011;20(4):369–77.CrossRefPubMedGoogle Scholar
  77. 77.
    Alanee S, Russo P. Suicide in men with testis cancer. Eur J Cancer Care (Engl). 2012;21(6):817–21.CrossRefGoogle Scholar
  78. 78.
    Bloom L, Shelton B, Bengough M, Brennan L. Psychosocial outcomes of a non-dieting based positive body image community program for overweight adults: a pilot study. J Eat Disord. 2013;1:44.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Rosen A, Rodriguez-Wallberg KA, Rosenzweig L. Psychosocial distress in young cancer survivors. Semin Oncol Nurs. 2009;25:268–77.CrossRefPubMedGoogle Scholar
  80. 80.
    Trask PC, Paterson AG, Fardig J, Smith DC. Course of distress and quality of life in testicular cancer patients before, during, and after chemotherapy: results of a pilot study. Psycho-Oncology. 2003;12:814–20.CrossRefPubMedGoogle Scholar
  81. 81.
    Bizet P, Saias-Magnan J, Jouve E, Grillo JM, Karsenty G, Metzler-Guillemain C, et al. Sperm cryopreservation before cancer treatment: a 15-year monocentric experience. Reprod Biomed Online. 2012;24(3):321–30.CrossRefPubMedGoogle Scholar
  82. 82.
    Freour T, Mirallie S, Jean M, Barriere P. Sperm banking and assisted reproductive outcome in men with cancer: a 10 years’ experience. Int J Clin Oncol. 2012;17(6):598–603.CrossRefPubMedGoogle Scholar
  83. 83.
    Johnson MD, Cooper AR, Jungheim ES, Lanzendorf SE, Odem RR, Ratts VS. Sperm banking for fertility preservation: a 20-year experience. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):177–82.CrossRefPubMedGoogle Scholar
  84. 84.
    Crha I, Ventruba P, Zakova J, Huser M, Kubesova B, Hudecek R, et al. Survival and infertility treatment in male cancer patients after sperm banking. Fertil Steril. 2009;91(6):2344–8.CrossRefPubMedGoogle Scholar
  85. 85.
    Lawson AK, Klock SC, Pavone ME, Hirshfeld-Cytron J, Smith KN, Kazer RR. Psychological counseling of female fertility preservation patients. J Psychosoc Oncol. 2015;33(4):333–53.CrossRefPubMedPubMedCentralGoogle Scholar
  86. 86.
    Lawson AK, Zweifel JE, Klock SC. Blurring the line between life and death: a review of the psychological and ethical concerns related to posthumous-assisted reproduction. Eur J Contracept Reprod Health Care. 2016;21(5):339–46.CrossRefPubMedGoogle Scholar
  87. 87.
    Pastuszak AW, Lai WS, Hsieh TC, Lipshultz LI. Posthumous sperm utilization in men presenting for sperm banking: an analysis of patient choice. Andrology. 2013;1:251–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyNorthwestern UniversityChicagoUSA

Personalised recommendations