TY - JOUR
T1 - Patient factors associated with sperm cryopreservation among at-risk adolescents newly diagnosed with cancer
AU - Klosky, James L.
AU - Lehmann, Vicky
AU - Flynn, Jessica S.
AU - Su, Yin
AU - Zhang, Hui
AU - Russell, Kathryn M.
AU - Schenck, Lauren A.M.
AU - Schover, Leslie R.
N1 - Funding Information: Supported in part by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (grant HD061296; J. Klosky, Principal Investigator) and United States Public Health Service grant CA-21765 (C. Roberts, Principal Investigator), with additional support provided to St. Jude Children’s Research Hospital from the American Lebanese Syrian Associated Charities (ALSAC). Publisher Copyright: © 2018 American Cancer Society Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - BACKGROUND: Although survivors of adolescent-onset cancers are at risk of infertility, the majority desire children. Fertility preservation options are available for adolescents, but sperm banking remains underused. To the authors' knowledge, patient factors that influence decisions to bank sperm are poorly understood. METHODS: A cross-sectional study of 146 adolescent males who were newly diagnosed with cancer and who completed surveys within 1 week of treatment initiation was performed. Participants, 65% of whom were white, were aged 13 to 21 years (mean, 16.49 years; standard deviation, 2.02 years) and were at risk of infertility secondary to impending gonadotoxic treatment. Participating institutions included 8 leading pediatric oncology centers across the United States and Canada. RESULTS: Of the patients approached, approximately 80.6% participated. Parent recommendation to bank (odds ratio [OR], 4.88; 95% confidence interval [95% CI], 1.15-20.71 [P =.03]), higher Tanner stage (OR, 4.25; 95% CI, 1.60-11.27 [P <.01]), greater perceived benefits (OR, 1.41; 95% CI, 1.12-1.77 [P <.01]), and lower social barriers to banking (OR, 0.88; 95% CI, 0.81-0.96 [P <.01]) were found to be associated with adolescent collection attempts, whereas meeting with a fertility specialist (OR, 3.44; 95% CI, 1.00-11.83 [P =.05]), parent (OR, 3.02; 95% CI, 1.12-8.10 [P =.03]) or provider (OR, 2.67; 95% CI, 1.05-6.77 [P =.04]) recommendation to bank, and greater adolescent self-efficacy to bank (OR, 1.16; 95% CI, 1.01-1.33 [P =.03]) were found to be associated with successful sperm banking. CONCLUSIONS: Adolescents' perceived benefits of sperm banking, higher Tanner stage, and parent recommendation were associated with collection attempts, whereas perceived social barriers decreased this likelihood. Successful banking was associated with greater adolescent self-efficacy, parent and provider recommendation to bank, and consultation with a fertility specialist. Providers should consult with both adolescents and parents regarding fertility preservation, and interventions should be tailored to address barriers to sperm banking while promoting its benefits.
AB - BACKGROUND: Although survivors of adolescent-onset cancers are at risk of infertility, the majority desire children. Fertility preservation options are available for adolescents, but sperm banking remains underused. To the authors' knowledge, patient factors that influence decisions to bank sperm are poorly understood. METHODS: A cross-sectional study of 146 adolescent males who were newly diagnosed with cancer and who completed surveys within 1 week of treatment initiation was performed. Participants, 65% of whom were white, were aged 13 to 21 years (mean, 16.49 years; standard deviation, 2.02 years) and were at risk of infertility secondary to impending gonadotoxic treatment. Participating institutions included 8 leading pediatric oncology centers across the United States and Canada. RESULTS: Of the patients approached, approximately 80.6% participated. Parent recommendation to bank (odds ratio [OR], 4.88; 95% confidence interval [95% CI], 1.15-20.71 [P =.03]), higher Tanner stage (OR, 4.25; 95% CI, 1.60-11.27 [P <.01]), greater perceived benefits (OR, 1.41; 95% CI, 1.12-1.77 [P <.01]), and lower social barriers to banking (OR, 0.88; 95% CI, 0.81-0.96 [P <.01]) were found to be associated with adolescent collection attempts, whereas meeting with a fertility specialist (OR, 3.44; 95% CI, 1.00-11.83 [P =.05]), parent (OR, 3.02; 95% CI, 1.12-8.10 [P =.03]) or provider (OR, 2.67; 95% CI, 1.05-6.77 [P =.04]) recommendation to bank, and greater adolescent self-efficacy to bank (OR, 1.16; 95% CI, 1.01-1.33 [P =.03]) were found to be associated with successful sperm banking. CONCLUSIONS: Adolescents' perceived benefits of sperm banking, higher Tanner stage, and parent recommendation were associated with collection attempts, whereas perceived social barriers decreased this likelihood. Successful banking was associated with greater adolescent self-efficacy, parent and provider recommendation to bank, and consultation with a fertility specialist. Providers should consult with both adolescents and parents regarding fertility preservation, and interventions should be tailored to address barriers to sperm banking while promoting its benefits.
KW - adolescent
KW - cryopreservation
KW - male infertility
KW - oncology
KW - psychology
UR - http://www.scopus.com/inward/record.url?scp=85050944971&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/cncr.31596
DO - https://doi.org/10.1002/cncr.31596
M3 - Article
C2 - 29975417
SN - 0008-543X
VL - 124
SP - 3567
EP - 3575
JO - Cancer
JF - Cancer
IS - 17
ER -