Access patterns and structural constraints in sperm cryopreservation for male cancer patients: a 12-year experience from Western Algeria

Abstract

International guidelines recommend fertility preservation counseling for cancer patients. However, implementation in resource-limited settings remains insufficiently documented. This study describes access patterns and structural constraints among male cancer patients who accessed sperm cryopreservation services in Western Algeria. A retrospective descriptive study including 98 male cancer patients who underwent sperm cryopreservation at El-Mawloud ART Center between 2009 and 2021. Utilization patterns were assessed through annual referral rates, patient demographics, cancer types, referral sources, and timing of cryopreservation. Structural constraints were described at patient (economic and geographic factors), provider (referral patterns and awareness), and system (service provision and financing) levels. Ninety-eight patients accessed services over 12 years (mean 7.69 patients/year). Mean age was 30.48 ± 8.12 years; 11.2% were aged 41–60 years. All services were provided in the private sector with 100% out-of-pocket payment. Most patients (67.3%) were unemployed or students. 62% traveled from outside Oran. Physician referral occurred in 75.5% of cases, while 24.5% identified services independently. Among those accessing services, 93.9% completed cryopreservation before treatment initiation. This study describes access patterns and identifies structural constraints affecting sperm cryopreservation services in Western Algeria. While clinical timing was appropriate among patients who reached the center, financial, geographic, and organizational factors may influence service accessibility. The magnitude of unmet need cannot be determined from this dataset and warrants prospective population-based investigation.