Pre-chemotherapy preservation of fertility in male patients with high-grade malignant bone and soft tissue tumors

Only a limited number of orthopedic oncologists make arrangements for pre-chemotherapy fertility preservation, such as sperm cryopreservation, for their patients. The purpose of this study was to offer fertility preservation to male patients with high-grade malignant bone and soft tissue tumors and assess the outcomes. The study included 14 male patients, aged <45 years, with high-grade bone and soft tissue tumors. The median age at diagnosis was 23.0±12.0 years (range, 8-42 years). Following pathological confirmation of high-grade malignant tumor, we informed all the patients and/or their guardians on the issue of chemotherapy-related male infertility. If the patients were interested in preserving fertility, they were referred to a team of reproductive specialists. We documented the patients' clinical characteristics and techniques used for fertility preservation. The majority of unmarried and childless patients were interested in fertility preservation. Four patients (28.5%) selected sperm cryopreservation and 1 patient (7.1%) selected hemi-testicular preservation, as he had developed erectile dysfunction following previous surgery for colon cancer. Married patients and those with children did not wish to preserve fertility. In conclusion, infertility following chemotherapy raises serious concerns for young male patients with high-grade bone and soft tissue tumors. Prior to initiating chemotherapy, the potential risks of chemotherapy should be explained, counseling should be provided and informed consent should be obtained from the patients, ideally without delaying commencement of cancer treatment. Prior to administering cancer chemotherapy, orthopedic oncologists are encouraged to offer sperm banking to young male patients at risk of infertility.