1 Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
2 Department of Pediatrics, The Ohio State University, Columbus, Ohio.
J Adolesc Young Adult Oncol. 2019 Feb;8(1):61-66. doi: 10.1089/jayao.2018.0094. Epub 2018 Sep 27.
As many as two-thirds of male childhood cancer survivors are at risk for fertility impairment as a consequence of treatment. Despite this, survivorship guidelines lack concrete recommendations as to when fertility status conversations should happen between patients and providers and what should be discussed. Thus, conversations may be inconsistent, or do not occur at all in survivorship. To inform recommendations for fertility-related conversations in survivorship, this pilot study aimed to better understand background (e.g., age, diagnosis and treatment intensity) and psychosocial factors (i.e., perceived barriers and perceived susceptibility) associated with survivor interest in learning about fertility status.
Male survivors (N = 45) 15-25 years of age were recruited within 1-8 years of completing treatment. Survivors completed questionnaires based on the Health Belief Model (HBM) to assess perception of infertility risk and attitudes toward testing.
Most survivors (n = 31; 69%) reported they were informed of their risk for infertility by a healthcare provider before treatment, but only 31% (n = 14) of the sample banked sperm. Nearly two-thirds of survivors (n = 29; 64%) were interested in learning more about their fertility post-treatment. This interest was significantly correlated with greater perceived susceptibility to infertility by survivors, but it was not associated with other psychosocial or background factors.
Informing survivors of their personal infertility risk may increase interest in pursuing testing. Offering opportunities for fertility testing and family planning alternatives may mitigate potential psychological distress and unplanned pregnancy. While additional research is needed, future survivorship guidelines should encourage regular communication about fertility status and offer fertility testing for male survivors.
多达三分之二的男性儿童癌症幸存者因治疗而面临生育能力受损的风险。尽管如此，生存指南缺乏关于患者和提供者之间何时应该进行生育状况对话以及应该讨论哪些内容的具体建议。因此，这些对话可能不一致，或者在生存中根本没有发生。为了为生存相关的生育问题对话提供信息，这项试点研究旨在更好地了解与幸存者对了解生育状况的兴趣相关的背景（例如，年龄、诊断和治疗强度）和心理社会因素（即，感知障碍和感知易感性）。
在完成治疗后 1 至 8 年内，招募了 15 至 25 岁的男性幸存者（N=45）。幸存者根据健康信念模型（HBM）完成了问卷，以评估对不孕风险的感知和对测试的态度。
大多数幸存者（n=31；69%）报告在治疗前曾从医疗保健提供者那里得知他们的不孕风险，但只有 31%（n=14）的样本进行了精子储存。近三分之二的幸存者（n=29；64%）对治疗后了解更多关于自己生育能力的信息感兴趣。这种兴趣与幸存者对不孕的感知易感性显著相关，但与其他心理社会或背景因素无关。
告知幸存者其个人不孕风险可能会增加他们对测试的兴趣。提供生育测试和计划生育替代方案的机会可能会减轻潜在的心理困扰和意外怀孕的风险。虽然需要进一步研究，但未来的生存指南应鼓励定期讨论生育状况，并为男性幸存者提供生育测试。
