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

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.

Fertility discussions and concerns in childhood cancer survivors, a systematic review for updated practice

“…Family‐centered psychological interventions appear to be a better support to help patients and their families to make the best decision related to the availability of FP, according to the medical situation as well as socio‐cultural conditions/context. 94 , 95 …”

“…Their state of receptivity is the consequence of their level of psychological availability and of their knowledge about fertility (initial knowledge and additional knowledge learned during hospitalization through written documents and discussions with HCPs 30,31 ). Family‐centered psychological interventions appear to be a better support to help patients and their families to make the best decision related to the availability of FP, according to the medical situation as well as socio‐cultural conditions/context 94,95 …”

“…Family-centered psychological interventions appear to be a better support to help patients and their families to make the best decision related to the availability of FP, according to the medical situation as well as socio-cultural conditions/context. 94,95 However, some obstacles are economic: the practice of ovarian tissue cryopreservation is closely correlated with the country's legislation and health care funding. 73 While in France and Canada the cost of the procedure is supported by social solidarity, most countries in the world are not as accommodating.…”