Satisfaction with Fertility Preservation Decisions among Adolescent Males with Cancer: A Mixed Methods Study

Charleen I Theroux, Kylie N Hill, Anna L Olsavsky, James L Klosky, Nicholas D Yeager, Anthony Audino, Sarah H O'Brien, Gwendolyn P Quinn, Cynthia A Gerhardt, Leena Nahata, Charleen I Theroux, Kylie N Hill, Anna L Olsavsky, James L Klosky, Nicholas D Yeager, Anthony Audino, Sarah H O'Brien, Gwendolyn P Quinn, Cynthia A Gerhardt, Leena Nahata

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.

Keywords: adolescent and young adult oncology; decisional satisfaction; fertility preservation; sperm banking.

Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
Recruitment flowchart. Participation across study time points. * Three adolescents completed Visit 2 but did not complete Visit 1.

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