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儿童患者对生育力保存的认识和意识调查:谈论生育力保存是否会让儿童患者感到不适?

Survey of understanding and awareness of fertility preservation in pediatric patients: Is conversation about fertility preservation unpleasant for pediatric patients?

机构信息

Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.

Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Front Endocrinol (Lausanne). 2023 Jan 6;13:1074603. doi: 10.3389/fendo.2022.1074603. eCollection 2022.

DOI:10.3389/fendo.2022.1074603
PMID:36686445
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9853553/
Abstract

OBJECTIVE

To verify understanding and awareness of fertility preservation (FP) in pediatric patients undergoing FP treatments.

METHODS

A questionnaire survey was conducted before and after explanation of fertility issues and FP treatments for patients 6-17 years old who visited or were hospitalized for the purpose of ovarian tissue cryopreservation (OTC) or oocyte cryopreservation (OC), or sperm cryopreservation between October 2018 and April 2022. This study was approved by the institutional review board at St. Marianna University School of Medicine (No. 4123, UMIN000046125).

RESULT

Participants in the study comprised 36 children (34 girls, 2 boys). Overall mean age was 13.3 ± 3.0 years. The underlying diseases were diverse, with leukemia in 14 patients (38.9%), brain tumor in 4 patients (11.1%). The questionnaire survey before the explanation showed that 19 patients (52.8%) wanted to have children in the future, but 15 (41.7%) were unsure of future wishes to raise children. And most children expressed some degree of understanding of the treatment being planned for the underlying disease (34, 94.4%). Similarly, most children understood that the treatment would affect their fertility (33, 91.7%). When asked if they would like to hear a story about how to become a mother or father after FP which including information of FP, half answered "Don't mind" (18, 50.0%). After being provided with information about FP treatment, all participants answered that they understood the adverse effects on fertility of treatments for the underlying disease. Regarding FP treatment, 32 children (88.9%) expressed understanding for FP and 26 (72.2%) wished to receive FP. "Fear" and "Pain" and "Costs" were frequently cited as concerns about FP. Following explanations, 33 children (91.7%) answered "Happy I heard the story" and no children answered, "Wish I hadn't heard the story". Finally, 28 of the 34 girls (82.4%) underwent OTC and one girl underwent OC.

DISCUSSION

The fact that all patients responded positively to the explanations of FP treatment is very informative. This is considered largely attributable to the patients themselves being involved in the decision-making process for FP.

CONCLUSIONS

Explanations of FP for children appear valid if age-appropriate explanations are provided.

摘要

目的

验证接受生育力保存(FP)治疗的儿科患者对 FP 的理解和认识。

方法

2018 年 10 月至 2022 年 4 月,对因卵巢组织冷冻保存(OTC)或卵母细胞冷冻保存(OC)或精子冷冻保存而就诊或住院的 6-17 岁患者进行生育问题和 FP 治疗的解释前后进行问卷调查。本研究经 St. Marianna 大学医学院机构审查委员会批准(UMIN000046125,编号 4123)。

结果

研究对象包括 36 名儿童(34 名女孩,2 名男孩)。平均年龄为 13.3 ± 3.0 岁。基础疾病多种多样,白血病 14 例(38.9%),脑肿瘤 4 例(11.1%)。解释前的问卷调查显示,19 名患者(52.8%)未来有生育子女的愿望,但 15 名(41.7%)对未来生育子女的愿望不确定。大多数儿童对计划治疗基础疾病的治疗有一定程度的理解(34 名,94.4%)。同样,大多数儿童了解治疗会影响他们的生育能力(33 名,91.7%)。当被问及是否愿意听一个关于 FP 后如何成为父母的故事,其中包括 FP 的信息时,一半的人回答“不介意”(18 名,50.0%)。在提供了 FP 治疗信息后,所有参与者均表示理解治疗基础疾病的不良生育影响。关于 FP 治疗,32 名儿童(88.9%)对 FP 表示理解,26 名儿童(72.2%)希望接受 FP。“恐惧”“疼痛”和“费用”经常被认为是对 FP 的担忧。解释后,33 名儿童(91.7%)回答“很高兴听到这个故事”,没有儿童回答“希望没有听到这个故事”。最后,34 名女孩中有 28 名(82.4%)接受了 OTC,1 名女孩接受了 OC。

讨论

所有患者对 FP 治疗的解释均给予积极回应,这一事实非常有意义。这主要归因于患者自身参与 FP 的决策过程。

结论

如果提供适合年龄的解释,对儿童进行 FP 解释似乎是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/ab94bfafb7bb/fendo-13-1074603-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/1cacbe0499c6/fendo-13-1074603-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/d55731cad99e/fendo-13-1074603-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/d3df297433c0/fendo-13-1074603-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/2ff5a6660e57/fendo-13-1074603-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/ab94bfafb7bb/fendo-13-1074603-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/1cacbe0499c6/fendo-13-1074603-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/d55731cad99e/fendo-13-1074603-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/d3df297433c0/fendo-13-1074603-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/2ff5a6660e57/fendo-13-1074603-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873f/9853553/ab94bfafb7bb/fendo-13-1074603-g005.jpg

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