title: Quebec public funding facilitates fertility preservation for male cancer patients.
abstract: BACKGROUND
  Sperm cryopreservation remains the only clinically feasible option to preserve male fertility. The quality of counselling provided by the treating physicians and the cost of sperm cryopreservation can both influence a patient's decision about whether to preserve sperm. On 5 August 2010, the Quebec government introduced provincial coverage of assisted reproductive technologies, with sperm cryopreservation included as a covered service. The aim of the present study was to evaluate whether and how such a program affects the behaviour of cancer patients with respect to sperm cryopreservation.
  
  
  METHODS
  We analyzed the database derived from male patients undergoing sperm cryopreservation from August 2008 to August 2012 at our centre. The retrieved data included patient age, male infertility or oncologic diagnosis, sperm quality parameters, and details about the number of visits for sperm cryopreservation.
  
  
  RESULTS
  The number of cancer patients who cryopreserved sperm before and after the policy change did not differ significantly, but a marked increase in the number of non-cancer patients was observed. Further analysis revealed that, after implementation of the public funding program, the total number of sperm cryopreservation sessions per patient increased significantly in cancer patients but not in non-cancer patients.
  
  
  CONCLUSIONS
  It appears that cancer patients who are willing to freeze sperm are keen to return for more sessions of sperm banking when no fees are associated with the service. Those findings suggest that cost reduction is an important factor for improving delivery of fertility preservation services to male cancer patients.
authors.affiliation: Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC;
authors.forename: M B
authors.initials: MB
authors.lastname: Herrero
authors.affiliation: Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC;
authors.forename: A
authors.initials: A
authors.lastname: García
authors.affiliation: Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC;
authors.forename: W
authors.initials: W
authors.lastname: Buckett
authors.affiliation: Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC;
authors.forename: T
authors.initials: T
authors.lastname: Tulandi
authors.affiliation: Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC;; Department of Urology, McGill University Health Centre, Montreal, QC.
authors.forename: P
authors.initials: P
authors.lastname: Chan
keywords: Male fertility preservation; assisted reproductive technologies; costs