Barriers to Sperm Banking 影响精子储存的几大因素

分类:医学文献 38 0

Even though sperm banking is a safe and effective procedure for storing sperm, only few patients who could benefit from it actually choose to do so (1). Authors of a qualitative study of 20 cancer survivors and 18 healthcare professionals conducted in-depth interviews to examine their perspectives on factors that facilitate or hinder sperm banking. The study found a few factors that have an impact on sperm banking:

尽管精子储存是保存精子安全有效的手段,但实际上只有少数能够受益于此的患者才会选择存储精子(数据参考见1)。有研究者对20名癌症幸存者和18名医疗专家进行定性研究,通过对研究者进行深入访谈了解他们对促进或阻碍精子储存因素的看法。研究发现精子储存受以下多个因素影响:

Priority 重要性

Sperm banking is usually not a priority for patients who have already completed their family and those who do not want to have children. Patients who are too young fail to understand the impact of infertility and do not consider sperm banking as a priority (1).

对于已有孩子的人群和不想生孩子的人群,精子储存通常不是他们优先考虑的事项。太年轻的患者无法理解不育的影响,也不会将精子储存作为优先考虑的事项(数据参考见1)。

Cost 花费

The cost of sperm banking is not covered by most insurance companies and may be a very important factor for patients with low incomes. Healthcare professionals are likely to presume that the costs are too high for their patients (2), and therefore may fail to mention it as an option.

大多数保险公司不报销精子储存相关的费用,这可能是低收入患者不考虑精子储存的一个非常重要的因素。医疗专家可能会认为精子储存的费用对他们的患者而言太过高昂(数据参考见2),因此可能根本不会对患者提及此选项。

Time Interval 时间间隔

Many patients with cancer or other serious diseases understandably want to start therapy as soon as they receive a diagnosis. As a result, they may not want to postpone their treatment to bank their sperm.

可以理解,许多患有癌症或其他严重疾病的患者一旦确诊就希望立即开始治疗。 这会导致他们可能不希望因为精子储存而推迟治疗。

Lack of Information 信息缺乏

Surveys show that the lack of timely information is the most common reason for not banking sperm (3). According to a study that surveyed oncologists to determine their knowledge, attitudes, and practices regarding sperm banking, 91 percent of respondents agreed that it should be offered to all men at risk of infertility as a result of cancer treatment. However, almost half reported that they did not mention the option to all eligible male patients due to a lack of time for the discussion, perceived high cost,and lack of convenient facilities. HIV-positive men, patients with a poor prognosis, or those with aggressive tumors are evenless likely to be offered the option of sperm banking (4).

调查显示,不进行精子存储的最常见原因是无法及时获取相关的信息(数据参考见3)。一项针对肿瘤学家们对精子储存的见解,态度和操作的研究的调查显示91%的受访者认为应将精子储存的选项提供给所有因癌症治疗而有不育风险的男性。 然而,几乎有一半的受访者称,由于没有足够的时间和患者讨论此事,成本高昂且缺乏便利的设施,他们没能向所有符合条件的男性患者提及精子存储。艾滋病患者,预后较差的患者或恶性肿瘤的患者极少有可能选择精子存储(数据参考见4)。

Religious or Ethical Concerns about Sperm Banking精子储存所涉及的宗教或道德担忧

The practice of sperm donation is opposed by many religions and hence, the option of sperm banking may not be acceptable to couples or physicians due to religious reasons. Many ethical issues are raised regarding the rights and obligations of the mother, the husband,and the child (5).

许多宗教反对精子捐赠给他人,因此,由于宗教信仰的原因,一些患者伴侣或医生可能无法接受精子储存的做法。母亲,丈夫和孩子的权利与义务也引发了许多道德问题(数据参考见5)。

Reference 数据参考:

1. Achille MA, Rosberger Z, Robitaille R, Lebel S,Gouin JP,Bultz BD, et al. Facilitators and obstacles to sperm banking in youngmen receiving gonadotoxic chemotherapy for cancer: theperspective of survivors and health care professionals. HumReprod 2006; 21 (12) : 3206-16.

2. NijsM,VanderzwalmenP,Vandamme B,Segal-Bertin G,Lejeune B,Segal L, et al. Fertilizing ability of immotile spermatozoa after intra-cytoplasmic sperm injection. Hum Reprod 1996;11(10):2180-5.

3. De Vries MC, Bresters D, Engberts DP, Wit JM, van Leeuwen E. Attitudes of physicians and parents towards discussing infertility risks and semen cryopreservation with male adolescents diagnosed with cancer. Pediatr Blood Cancer 2009;53(3):386-91

4. Schover LR, Brey K, Lichtin A, Lipshultz LI, Jeha S. Oncologists’attitudes and practices regarding banking sperm before cancertreatment. J Clin Oncol 2002; 20 (7) : 1890-7.

5. Meirow D,Schenker JG. The current status of sperm donationin assisted reproduction technology:ethical and legal consider-ations. J Assist Reprod Genet 1997; 14 (3) : 133-8.

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