When to ask male adolescents to provide semen sample for fertility preservation?

Abstract

Background: Fertility preservation in adolescents undergoing sterilizing radiation and/or chemotherapy is the standard of care in oncology. The opportunity for patients to provide a semen sample by ejaculation is a critical issue in adolescent fertility preservation.

Methods: Fifty males with no medical or sexual developmental abnormalities were evaluated. The subjects were screened for evidence of orgasmic, erectile, and ejaculatory dysfunction. A detailed sexual development history was obtained under an Institutional Review Board (IRB)-approved protocol.

Results: Fifty males, aged 18-65 years (mean 39±16.03 years) volunteered to be part of this study. The mean reported age for the onset of puberty was 12.39 years (95% CI, 11.99-12.80 years), 13.59 years (95% CI, 13.05-14.12 years) for the first ejaculation, 12.56 years (95% CI, 11.80-13.32 years) for the start of masturbation, and 17.26 years (95% CI, 16.18-18.33 years) for the first experienced intercourse. Seventy-five percent of the cohort reached puberty by the age of 13.33, experienced masturbation by 14.5, first ejaculated by the age of 14.83, and had intercourse at age of 19.15 years. The first experienced ejaculation fell 1.5 years after the onset of puberty in 80% present of the cohort, and 84% starts masturbation 1.5 years after the onset of puberty. The mean response between the younger and the older subject was not statistical significance.

Conclusions: It is appropriate to consider a request for semen specimens by masturbation from teenagers at one year and six months after the onset of puberty; the onset age of puberty plus 1.5 years is an important predictor of ejaculation and sample collection for cryopreservation.

Keywords: Fertility preservation; adolescents; cancer management; ejaculation; masturbation; semen collection.

Figure 1

Cumulative age for (A) start of puberty; (B) start of masturbation; (C) first experienced ejaculation; (D) first experienced intercourse.

Figure 2

Distribution of age for (A) start of puberty; (B) start of masturbation; (C) first experienced ejaculation; (D) first experienced intercourse. Highlighted mark is the mean age for the start of puberty with the 95% CI.

Figure 3

Linear regression analysis between the first experienced Ejaculations and (A) start of puberty; (B) first experienced intercourse; (C) start of masturbation.