Satisfaction, disappointment and regret surrounding fertility preservation decisions in the paediatric and adolescent cancer population

“We Can Always Adopt”: Perspectives of Adolescent and Young Adult Males with Cancer and Their Family on Alternatives to Biological Parenthood

“…13,31 Furthermore, fertility counseling and both declining or completing FP before treatment decrease future regret. 32 Thus, communication about FP and alternatives to biological parenthood should begin at the time of a new cancer diagnosis between physicians, parents, and AYAs at risk for future infertility. Families should discuss future parenthood goals (including adoption logistics, sperm donation, or a life without children) to make optimal decisions about FP and mitigate future regret or disappointment.…”

Communication and ethical considerations for fertility preservation for patients with childhood, adolescent, and young adult cancer: recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group

“…Evidence concerning barriers to communication of infertility risk and fertility preservation showed varying levels of evidence. In regard to patient and family perspectives, there is moderate-quality evidence that poor physical status and a highly stressed emotional status of patients; 25,[41][42][43][44][45][46][47] time constraints regarding delaying treatment; 25,[45][46][47][48]55 costs; 43,45,53 absence of interest; 44,45,48 experimental nature of the procedure for fertility preservation with the associated risks; 25,42,45,46,48,53,54 highly stressed emotional status of parents; 44,54,56 absence of parental or medical recommendation; 49,50 absence of patient self-efficacy for banking; 50,51 absence of experience with, taboo regarding, and embarrassing feelings with masturbation; 25,49 cultural and religious beliefs; 41,45 poor success rate of the procedure for fertility preservation procedure; 45,46 and young age at diagnosis 40,52 • Some parents of male patients diagnosed at younger than 18 years want to control whether physicians discuss sperm banking with their child (very low-quality ...…”

“…• Patient with poor emotional or physical status, or both (moderate-quality evidence) 25,41-47 • Absence of interest (moderate-quality evidence) 44,45,48 • Scarcity of experience with, taboo related to, and embarrassing feelings with masturbation (moderate-quality evidence) 25,49 • Absence of patient self-efficacy for banking (moderatequality evidence) 50,51 * • Young age at diagnosis (moderate-quality evidence) 40,52 • Insufficient information (low-quality evidence) 43 Procedure-related barriers: • Experimental nature of the procedure for fertility preservation with the associated risks or complications (moderate-quality evidence) 25,42,45,46,48,53,54 • Time constraints regarding delaying treatment (moderatequality evidence) 25,[45][46][47][48]55 • Costs (moderate-quality evidence) 43,45,53 • Poor success rate of the procedure for fertility preservation (moderate-quality evidence) 45,46 Parent-related barriers: • Parents have a highly stressed emotional status (moderatequality evidence) 44,54,56 • Absence of parental or medical team recommendation, or both (moderate-quality evidence) 49,50 • Cultural or religious beliefs (moderate-quality evidence) 41,45 • Sensitive nature of the conversation about fertility preservation (parent-reported barrier; low-quality evidence) 24 • Absence of parental self-efficacy (low-quality evidence) 49 Barriers related to health-care providers and institutions: • Absence of specific consultation by fertility specialist (low-quality evidence) 57 • Difficulty in finding proper facilities (low-quality evidence) 45 • Adult treatment centre versus non-adult treatment centre (low-quality evidence)…”

Psychosocial benefits of sperm banking might outweigh costs

“…Indeed, although numerous studies have shown distress and regret among survivors and their partners about missed opportunities for fertility preservation 2,3 , to our knowledge no research has shown regret among those who banked sperm, regardless of whether they used their samples. In fact, studies have shown regret among those who did not pursue a fertility preservation method 8 and a lower emotional burden of potential infertility in men who had cryopreserved samples before cancer treatment 9 .…”