Impact of Demographics and Number of IVF Cycles on Oncofertility Information for Men With Cancer: Content Analysis of NCI Designated Cancer Center

Document Type


Publication Date


Publication Title

Fertility and Sterility





First page number:


Last page number:



BACKGROUND: Fertility preservation is often overlooked in patient counseling following cancer diagnosis. OBJECTIVE: The aim of this study was to compare the availability of patient directed information on male fertility preservation on the web sites of National Cancer Institute designated cancer centers (NCICC) between 2015 and 2020 and to determine the influence of demographics and presence of nearby fertility centers on access to male oncofertility information. MATERIALS AND METHODS: All NCICC web sites were queried in a systematic fashion for patient directed information on the effect of cancer treatment on male fertility in 2015 and again in 2020. A rubric was employed to establish minimum content quality standards for the validation process. Independent research teams from two institutions validated data collected from each web site. Data was evaluated based on the number of fertility clinics in a city/county and the yearly number of in vitro fertilization cycles (IVF) in each city/county. Data was additionally evaluated based on each cancer center’s regional population and race to test whether there was a demographic effect on male oncofertility information using data from US Census Bureau (2014-2018) within the population. Websites of clinics reporting data to the Society for Assisted Reproductive Technology from the most recent complete year (2017) were queried. Chi-square analyses of the top and bottom quartiles of various socioeconomic factors such as population density, income per capita, percent population without insurance, median household income, percent college degree, percent with a high school degree, and percent other language spoken at home. RESULTS: All web sites of NCICC were evaluated, there were 62 centers in 2015 and 65 in 2020. Among all cancer centers, there was a significant increase in information on fertility preservation specifically directed toward men, such as sperm cryopreservation which is increased from 60% in 2015 to 70% in 2020 (p= 0.014). There is a statistically significant association between discussion of male fertility and the number of fertility centers in the county and state of the NCICC (p=0.04 and p=0.001). The number of IVF cycles done each year in the city, county and state of the NCICC was associated with an increased availability on the impact of cancer treatment on male fertility (p=0.041, p=0.001, p=0.001 respectively). NCICCs located in counties in the highest quartile of per capita income were significantly more likely to address male fertility (0.03). There is not a significant association between discussion of male fertility with percent insured, percent high school or college educated, and percent of population who speak a language other than English at home. CONCLUSION: Forty percent of NCICC web sites do not discuss options for male fertility preservation, and over one-third make no mention of the ramifications of cancer treatment on male fertility. NCICCs located in cities and counties with more fertility centers and a higher number of IVF cycles are more likely to address male oncofertility. Given the increasing recognition of the importance of oncofertility in cancer survivorship, more education should be available about options for fertility preservation, particularly among men.


Obstetrics and Gynecology | Oncology