The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
J Assist Reprod Genet. 2021 Jun;38(6):1561-1569. doi: 10.1007/s10815-021-02092-6. Epub 2021 Feb 10.
Over half of males experience fertility impairment after childhood cancer therapy, which often causes psychosocial distress. Yet, fertility preservation (FP) remains underutilized. The goals of this study were to determine the feasibility and impact of implementing a family-centered FP values clarification tool on sperm banking attempts among adolescent males newly diagnosed with cancer, and identify key determinants of banking attempts.
A prospective pilot study was conducted among families of males (12-25 years old), prior to cancer therapy. Thirty-nine of 41 families agreed to participate (95%); 98 participants (32 adolescents, 37 mothers, 29 fathers) completed the Family-centered Adolescent Sperm banking values clarification Tool (FAST). Analyses assessed the impact of the FAST on banking attempts and examined associations between demographic/medical characteristics, FAST subscales (perceived threat, benefits, barriers), and banking attempts.
Twenty-three (59%) adolescents attempted to bank, compared to 8 adolescents (33%) during baseline assessment (p=.04). Significant associations were identified between banking attempts and adolescents' report of perceived threat (r=.45, p=.01) and benefits (r=.57, p=.01). Only mothers' proxy reports of adolescent perceived threat (r=.42, p=.01) and benefits (r=.47, p=.003) were associated with banking attempts, while fathers' self-reported perceived benefits (r=.43, p=.03), self-reported barriers (r=.49, p=.01), and proxy reports of adolescent perceived threat (r=.38, p=.04) and benefits (r=.59, p=.02) were associated with banking attempts.
Adolescent sperm banking attempt rates significantly increased after implementation of a family-centered FP values clarification tool prior to cancer treatment. Findings underscore the importance of targeting both adolescents and their parents, particularly fathers, in FP efforts.
超过一半的男性在儿童癌症治疗后出现生育能力受损，这常常导致心理社会困扰。然而，生育力保存（FP）的应用仍然不足。本研究的目的是确定在新诊断为癌症的青少年男性中实施以家庭为中心的 FP 价值澄清工具对精子库尝试的可行性和影响，并确定银行尝试的关键决定因素。
在癌症治疗前，对 32 名青少年、37 名母亲和 29 名父亲进行了一项前瞻性试点研究。41 个家庭中有 39 个（95%）同意参与；98 名参与者（32 名青少年、37 名母亲、29 名父亲）完成了以家庭为中心的青少年精子库价值澄清工具（FAST）。分析评估了 FAST 对银行尝试的影响，并检查了人口统计学/医学特征、FAST 子量表（感知威胁、益处、障碍）与银行尝试之间的关联。
23 名（59%）青少年尝试银行，而基线评估时 8 名（33%）青少年尝试银行（p=.04）。银行尝试与青少年报告的感知威胁（r=.45，p=.01）和益处（r=.57，p=.01）之间存在显著关联。只有母亲代理报告的青少年感知威胁（r=.42，p=.01）和益处（r=.47，p=.003）与银行尝试相关，而父亲的自我报告感知益处（r=.43，p=.03）、自我报告障碍（r=.49，p=.01）以及代理报告的青少年感知威胁（r=.38，p=.04）和益处（r=.59，p=.02）与银行尝试相关。
在癌症治疗前实施以家庭为中心的 FP 价值澄清工具后，青少年精子库尝试率显著增加。研究结果强调了针对青少年及其父母，特别是父亲，开展 FP 工作的重要性。
