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Nahata L, Liles SM, Gerhardt CA, Housten AJ, Jalili D, O'Brien SH, Vadaparampil ST, Quinn GP. Clinicians' perspectives on barriers and facilitators to sperm banking in adolescent males with cancer: a mixed-methods study. J Assist Reprod Genet 2023; 40:2809-2817. [PMID: 37730946 PMCID: PMC10656382 DOI: 10.1007/s10815-023-02944-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
PURPOSE To examine processes, barriers, and facilitators to sperm banking counseling and decision-making for adolescent males newly diagnosed with cancer from the perspective of clinicians who completed Oncofertility communication training. We also identify opportunities for improvement to inform future interventions and implementation. METHODS A survey (N=104) and subsequent focus groups (N=15) were conducted with non-physician clinicians practicing in pediatric oncology who completed Oncofertility communication training. RESULTS Most survey participants were confident in communicating about the impact of cancer on fertility (n=87, 83.7%) and fertility preservation options (n=80, 76.9%). Most participants reported never/rarely using a sperm banking decision tool (n=70, 67.3%), although 98.1% (n=102) said a decision tool with a family-centered approach would be beneficial. Primary themes in the subsequent focus groups included variable processes/workflows (inconsistent approaches to consult initiation; involvement of adolescents, caregivers, and various clinician types; assessment of puberty/sexual experience), structural and psychosocial barriers (cost and logistics, developmental, cultural, clinical acuity/prognosis), and facilitators (educational materials, alternative options for banking). Opportunities and strategies for improvement (including fertility preservation in existing research protocols; additional staffing/resources; oncologist education and buy-in; and development of decision tools) were informed by challenges identified in the other themes. CONCLUSION Barriers to adolescent sperm banking remain, even among clinicians who have completed Oncofertility training. Although training is one factor necessary to facilitate banking, structural and psychosocial barriers persist. Given the complexities of offering sperm banking to pediatric populations, continued efforts are needed to mitigate structural barriers and develop strategies to facilitate decision-making before childhood cancer treatment.
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Affiliation(s)
- Leena Nahata
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St, Columbus, OH, 43205, USA.
- Nationwide Children's Hospital, Columbus, OH, USA.
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Sophia M Liles
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St, Columbus, OH, 43205, USA
| | - Cynthia A Gerhardt
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St, Columbus, OH, 43205, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ashley J Housten
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Dona Jalili
- Department of Obstetrics and Gynecology, NYU School of Medicine, New York, NY, USA
| | - Sarah H O'Brien
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St, Columbus, OH, 43205, USA
- Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Gwendolyn P Quinn
- Department of Obstetrics and Gynecology, NYU School of Medicine, New York, NY, USA
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2
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Pawłowski P, Ziętara KJ, Michalczyk J, Fryze M, Buchacz A, Zaucha-Prażmo A, Zawitkowska J, Torres A, Samardakiewicz M. Fertility Preservation in Children and Adolescents during Oncological Treatment-A Review of Healthcare System Factors and Attitudes of Patients and Their Caregivers. Cancers (Basel) 2023; 15:4393. [PMID: 37686669 PMCID: PMC10487203 DOI: 10.3390/cancers15174393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
Oncofertility is any therapeutic intervention to safeguard the fertility of cancer patients. Anti-cancer therapies (chemotherapy, radiation therapy, etc.) entail the risk of reproductive disorders through cytotoxic effects on gamete-building cells, especially those not yet fully developed. This literature review analyzes the available data on securing fertility in pediatric and adolescent populations to identify the methods used and describe aspects related to financing, ethics, and the perspective of patients and their parents. Topics related to oncofertility in this age group are relatively niche, with few peer-reviewed articles available and published studies mostly on adults. Compared to pubertal individuals, a limited number of fertility preservation methods are used for prepubertal patients. Funding for the procedures described varies from country to country, but only a few governments choose to reimburse them. Oncofertility of pediatric and adolescent patients raises many controversies related to the decision, parents' beliefs, having a partner, ethics, as well as the knowledge and experience of healthcare professionals. As the fertility of young cancer patients is at risk, healthcare professionals should make every effort to provide them with an opportunity to fulfill their future reproductive plans and to have a family and offspring. Systemic solutions should form the basis for the development of oncofertility in pediatric and adolescent populations.
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Affiliation(s)
- Piotr Pawłowski
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (J.M.)
| | - Karolina Joanna Ziętara
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (J.M.)
| | - Justyna Michalczyk
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (J.M.)
| | - Magdalena Fryze
- Department of Psychology, Psychosocial Aspects of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (M.F.); (M.S.)
| | - Anna Buchacz
- Youth Cancer Europe, 400372 Cluj-Napoca, Romania;
| | - Agnieszka Zaucha-Prażmo
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-093 Lublin, Poland; (A.Z.-P.); (J.Z.)
| | - Joanna Zawitkowska
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-093 Lublin, Poland; (A.Z.-P.); (J.Z.)
| | - Anna Torres
- Department of Pediatric and Adolescent Gynecology, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Marzena Samardakiewicz
- Department of Psychology, Psychosocial Aspects of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (M.F.); (M.S.)
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3
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Fertility preservation in male cancer patients: A mixed methods assessment of experiences and needs. Urol Oncol 2022; 40:385.e19-385.e25. [DOI: 10.1016/j.urolonc.2022.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/27/2022] [Accepted: 05/27/2022] [Indexed: 11/30/2022]
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4
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Fertility Testing Knowledge and Attitudes in Male Adolescents and Young Adults with SCD and Their Caregivers: A Pilot Study. Blood Adv 2022; 6:3703-3706. [PMID: 35442421 PMCID: PMC9631561 DOI: 10.1182/bloodadvances.2022007004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/23/2022] [Indexed: 11/25/2022] Open
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5
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Stanek C, Theroux CI, Olsavsky AL, Hill KN, Rausch JR, O’Brien SH, Quinn GP, Gerhardt CA, Nahata L. Study protocol for fertility preservation discussions and decisions: A family-centered psychoeducational intervention for male adolescents and emerging adults newly diagnosed with cancer and their families. PLoS One 2022; 17:e0263886. [PMID: 35171948 PMCID: PMC8849538 DOI: 10.1371/journal.pone.0263886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 11/19/2022] Open
Abstract
Many childhood cancer survivors desire biological children but are at risk for infertility after treatment. One option for mitigating risk is the use of fertility preservation prior to gonadotoxic therapy. Adolescents and emerging adults may rely on their parents to help them decide whether to use fertility preservation. While this is often a collaborative process, it is currently unknown how parents can optimally support adolescents and emerging adults through this decision. To address this gap, we developed a family-centered, psychoeducational intervention to prompt adolescents and emerging adults to reflect on their future parenthood goals and attitudes towards fertility preservation, as well as to prompt their parents (or other caregivers) to reflect on their own and their child's perspectives on the topic. In this randomized controlled trial, families will be randomized to either the standard of care control group (fertility consult) or the intervention group. After their fertility consult, adolescents and emerging adults and parents in the intervention group will complete a fertility preservation values clarification tool and then participate in a guided conversation about their responses and the fertility preservation decision. The primary expected outcome of this study is that participation in the intervention will increase the use of fertility preservation. The secondary expected outcome is an improvement in decision quality. Chi-square analyses and t-tests will evaluate primary and secondary outcomes. The goal of this intervention is to optimize family-centered fertility preservation decision-making in the context of a new cancer diagnosis to help male adolescents and emerging adults achieve their future parenthood goals.
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Affiliation(s)
- Charis Stanek
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Charleen I. Theroux
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Anna L. Olsavsky
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Kylie N. Hill
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Joseph R. Rausch
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Sarah H. O’Brien
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Gwendolyn P. Quinn
- New York University Grossman School of Medicine, New York, New York, United States of America
| | - Cynthia A. Gerhardt
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Leena Nahata
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- * E-mail:
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6
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Beauvais D, Berthaut I, Cabannes-Hamy A, Béhal H, Barraud-Lange DV, Pollet-Villard X, Lengliné E, Itzykson R, Andreoli A, Ricadat E, Dhédin N, Levy R, Poirot C, Boissel N. Semen Cryopreservation in Adolescents and Young Adults with Hematologic Diseases: from Bed to Benchside. J Adolesc Young Adult Oncol 2021; 11:389-393. [PMID: 34756112 DOI: 10.1089/jayao.2021.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Infertility in adolescents and young adult (AYA) survivors of malignant disease remains a major long-term adverse effect, but semen collection for fertility preservation in fertility centers is not always feasible and makes AYAs uncomfortable. We evaluated the feasibility of collecting sperm samples on the ward versus in fertility centers. Methods: Consecutive hospitalized AYA-aged male patients in the Hematology AYA unit (Saint-Louis Hospital, France) between August 2010 and June 2016 with hematological disease and indication of semen collection (n = 95) were included in this retrospective study. Semen quality was analyzed according to World Health Organization guidelines and was compared according to semen collection place: on the ward (n = 46) or in fertility center (n = 49). Results: The median age was median age 19.1 years (range: 13.7-33.3; interquartile range: 17.1-22.8) and 85 patients successfully collected semen. Sperm collection failure was ∼11% and was comparable between the two modalities as were main sperm quality characteristics (semen volume, sperm concentration, total sperm count, progressive motility and vitality, sperm morphology, and multiple anomalies index). Oligospermia was significantly higher in the samples obtained in fertility center (47.7%) than on the ward (26.8%), p = 0.047. Average frozen straws were comparable, 12.2 ± 6.4 on the ward versus 11.9 ± 6.3 in fertility center. Conclusion: Semen collection on the ward is feasible and would be particularly interesting for AYA male patients without altering semen quality characteristics.
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Affiliation(s)
- David Beauvais
- Service d'Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Isabelle Berthaut
- Service de Biologie de la Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Aurélie Cabannes-Hamy
- Service d'Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,URP-3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Hélène Béhal
- Université Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France.,Department of Biostatistics, CHU Lille, Lille, France
| | - Dr Virginie Barraud-Lange
- Unité INSERM 1016, Biologie de la Reproduction-CECOS, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | | | - Etienne Lengliné
- Service d'Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,URP-3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Raphaël Itzykson
- Service d'Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,URP-3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Annalisa Andreoli
- Service d'Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Elise Ricadat
- URP-3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France.,IHSS/CRPMS, La Personne en Médecine, ANR-18-IDEX-001, Université de Paris, Paris, France
| | - Nathalie Dhédin
- Service d'Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,URP-3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Rachel Levy
- Service de Biologie de la Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.,Faculty of Medicine, Sorbonne Université, Paris, France
| | - Catherine Poirot
- Service d'Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Faculty of Medicine, Sorbonne Université, Paris, France
| | - Nicolas Boissel
- Service d'Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,URP-3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
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7
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Nahata L, Olsavsky A, Dattilo TM, Lipak KG, Whiteside S, Yeager ND, Audino A, Rausch J, Klosky JL, O'Brien SH, Quinn GP, Gerhardt CA. Parent-Adolescent Concordance Regarding Fertility Perspectives and Sperm Banking Attempts in Adolescent Males With Cancer. J Pediatr Psychol 2021; 46:1149-1158. [PMID: 34333651 DOI: 10.1093/jpepsy/jsab069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/25/2021] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Approximately half of male childhood cancer survivors experience impaired fertility, yet fertility preservation (FP) remains underutilized. Although parent recommendation influences adolescents' decision-making, parents may be uncertain and/or underrate their sons' parenthood goals. This study assessed parent-adolescent and family-level concordance regarding adolescent fertility perspectives (i.e., values, goals) and associations with FP attempts. METHODS A prospective pilot study examined the impact of a family-centered values clarification tool (FAST) on banking attempts among adolescent males newly diagnosed with cancer at risk for infertility. The FAST assessed adolescent and parent perceptions of adolescents' fertility values and goals (i.e., perceived threat of infertility, perceived benefits/barriers to banking). Parent-adolescent concordance and family-level concordance on fertility perspectives were examined, along with associations with banking attempts and salient demographic factors. RESULTS Ninety-eight participants (32 adolescents aged 12-20, 37 mothers, 29 fathers) from 32 families completed the FAST before treatment initiation. Parent-adolescent dyads were concordant on approximately one-half of responses. Banking attempts were associated with higher family-level concordance regarding perceived benefits, r(32) = .40, p = .02. Older adolescent age was associated with higher family-level concordance regarding perceived threat, r(31) = .37, p = .04, and benefits, r(32) = .40, p = .03. Fathers' education was associated with higher family-level concordance regarding barriers, r(21) = .53, p = .01. CONCLUSIONS When parents were concordant with their son's fertility values and goals, particularly perceived benefits, adolescents were more likely to attempt FP. Clinicians should facilitate sharing of fertility perspectives within families before cancer treatment, especially with younger adolescents. Psychosocial support for families facing FP decisions is recommended at diagnosis and across the care continuum.
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Affiliation(s)
- Leena Nahata
- The Abigail Wexner Research Institute.,Nationwide Children's Hospital.,The Ohio State University College of Medicine
| | | | | | | | | | - Nicholas D Yeager
- Nationwide Children's Hospital.,The Ohio State University College of Medicine
| | - Anthony Audino
- Nationwide Children's Hospital.,The Ohio State University College of Medicine
| | - Joseph Rausch
- The Abigail Wexner Research Institute.,The Ohio State University College of Medicine
| | - James L Klosky
- Department of Pediatrics, Emory University School of Medicine & The Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta
| | - Sarah H O'Brien
- The Abigail Wexner Research Institute.,Nationwide Children's Hospital.,The Ohio State University College of Medicine
| | | | - Cynthia A Gerhardt
- The Abigail Wexner Research Institute.,The Ohio State University College of Medicine
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8
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Theroux CI, Hill KN, Olsavsky AL, Klosky JL, Yeager ND, Audino A, O’Brien SH, Quinn GP, Gerhardt CA, Nahata L. Satisfaction with Fertility Preservation Decisions among Adolescent Males with Cancer: A Mixed Methods Study. Cancers (Basel) 2021; 13:cancers13143559. [PMID: 34298773 PMCID: PMC8304836 DOI: 10.3390/cancers13143559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/30/2021] [Accepted: 07/11/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Fertility impairment is common among male childhood cancer survivors and negatively impacts quality of life. Sperm banking, before starting cancer treatment, is an established fertility preservation option, yet it remains underutilized at many pediatric centers. Although survivors often report regret about missed banking opportunities, little is known about short-term decisional satisfaction. The aim of this mixed methods study was to examine decisional satisfaction one month after diagnosis by comparing satisfaction among families of adolescents who did or did not attempt to bank. Quantitatively, families reported satisfaction regardless of the banking decision, while qualitatively, families of adolescents who did not attempt to bank reported potential for future regret. Thus, decisional dissatisfaction may not present after one month but could emerge in the future. The findings underscore the importance of longitudinal research to examine satisfaction over time, and why quantitative and qualitative discrepancies exist, as well as psychosocial support across the care continuum as survivors approach their reproductive years. Abstract Half of male childhood cancer survivors experience treatment-related fertility impairment, which can lead to distress. Survivors often regret forgoing fertility preservation (FP), and decisional dissatisfaction is associated with a lower quality of life. This mixed methods study examined short-term FP decisional satisfaction among families of male adolescents newly diagnosed with cancer who received an initial fertility consult and completed an FP values clarification tool. One-two months after the FP decision, thirty-nine families completed the Brief Subjective Decision Quality measure. Decisional satisfaction was compared for participants (mothers, fathers, adolescents) who did and did not attempt to bank. Semi-structured interviews included the following question: How do you/your family feel about the banking decision now/in the future? Decisional quality scores were moderate-high (M = 5.74–6.33 out of 7), with no significant differences between non-attempter (n = 15) and attempter (n = 24) families (adolescents: p = 0.83, d = 0.08; mothers: p = 0.18, d = 0.45; fathers: p = 0.32, d = 0.44). Three qualitative themes emerged among non-attempter families: (1) satisfaction with decision (50% of participants), (2) acceptance of decision (60%), and (3) potential for future regret (40%). Satisfaction with decision was the only theme identified in attempter families (93%). Quantitively, short-term decisional satisfaction was high regardless of the banking attempt. However, the qualitative findings suggest that the experiences of families who did not bank may be more nuanced, as several participants discussed a potential for future regret, highlighting the importance of ongoing support.
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Affiliation(s)
- Charleen I. Theroux
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (C.I.T.); (K.N.H.); (A.L.O.); (S.H.O.); (C.A.G.)
| | - Kylie N. Hill
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (C.I.T.); (K.N.H.); (A.L.O.); (S.H.O.); (C.A.G.)
| | - Anna L. Olsavsky
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (C.I.T.); (K.N.H.); (A.L.O.); (S.H.O.); (C.A.G.)
| | - James L. Klosky
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA 30329, USA;
| | - Nicholas D. Yeager
- Division of Hematology/Oncology, Nationwide Children’s Hospital, Columbus, OH 43205, USA; (N.D.Y.); (A.A.)
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Anthony Audino
- Division of Hematology/Oncology, Nationwide Children’s Hospital, Columbus, OH 43205, USA; (N.D.Y.); (A.A.)
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Sarah H. O’Brien
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (C.I.T.); (K.N.H.); (A.L.O.); (S.H.O.); (C.A.G.)
- Division of Hematology/Oncology, Nationwide Children’s Hospital, Columbus, OH 43205, USA; (N.D.Y.); (A.A.)
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY 10016, USA;
| | - Cynthia A. Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (C.I.T.); (K.N.H.); (A.L.O.); (S.H.O.); (C.A.G.)
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Leena Nahata
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (C.I.T.); (K.N.H.); (A.L.O.); (S.H.O.); (C.A.G.)
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
- Division of Endocrinology, Nationwide Children’s Hospital, Columbus, OH 43205, USA
- Correspondence: ; Tel.: +1-(614)-722-4502; Fax: +1-(614)-722-6980
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9
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Olsavsky A, Theroux CI, Dattilo TM, Klosky JL, O’Brien SH, Quinn GP, Gerhardt CA, Nahata L. Family communication about fertility preservation in adolescent males newly diagnosed with cancer. Pediatr Blood Cancer 2021; 68:e28978. [PMID: 33629820 PMCID: PMC8164973 DOI: 10.1002/pbc.28978] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/09/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Approximately half of male childhood cancer survivors experience fertility impairment, which can cause psychological distress. Sperm banking remains underutilized among adolescent males with cancer. Parent recommendation influences banking decisions, yet multi-informant studies have not been conducted to examine fertility preservation (FP) communication and decision making in this population. This study explored FP communication among mothers, fathers, and their male adolescents newly diagnosed with cancer. PROCEDURE Thirty-three male adolescents, 32 mothers, and 22 fathers completed semi-structured interviews 1-2 months after cancer diagnosis addressing this question: Tell me more about conversations you had about fertility preservation/sperm banking with your health care providers, parents/son, other family members, or anyone else. Interviews were audio-recorded and transcribed verbatim for thematic content analysis. RESULTS Five process themes emerged: (1) reliance on health care team and social support networks to facilitate FP decisions (only parents); (2) withholding parental opinion and deferring the decision to the adolescent; (3) ease of communication (primarily adolescents); (4) communication barriers/facilitators; (5) not being present or not remembering details of FP conversations with health care providers (primarily fathers and adolescents). Four content themes included: (1) preference for biological (grand)parenthood; (2) consideration of adolescent's future partner's desire for biological parenthood (primarily parents); (3) banking while it is a viable option; (4) openness to alternative parenthood options (e.g., adoption/fostering, primary parents). CONCLUSIONS Understanding variation in what family members discuss and consider relevant when making FP decisions is an important step toward improving pediatric oncofertility care. Interventions are needed to facilitate family FP-related conversations and optimize decisional satisfaction over time.
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Affiliation(s)
| | | | | | - James L. Klosky
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Sarah H. O’Brien
- The Abigail Wexner Research Institute, Columbus, OH,Nationwide Children’s Hospital, Columbus, OH,The Ohio State University, Columbus, OH
| | | | - Cynthia A. Gerhardt
- The Abigail Wexner Research Institute, Columbus, OH,The Ohio State University, Columbus, OH
| | - Leena Nahata
- The Abigail Wexner Research Institute, Columbus, OH,Nationwide Children’s Hospital, Columbus, OH,The Ohio State University, Columbus, OH
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