Factors affecting decision making about fertility preservation after cancer diagnosis: A qualitative study

Valerie Peddie, Maureen Anne Porter, R. Barbour, D. Culligan, G. MacDonald, D. King, J. Horn, Siladitya Bhattacharya

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Objective To increase our understanding of factors underlying the decision to store gametes after the diagnosis of cancer.

Design Qualitative interview study.

Setting Andrology, Haematology, and Oncology Departments of a Scottish teaching hospital, and patients’ own homes.

Population Sixteen men and 18 women aged 17–49 years recently diagnosed with cancer; 15 health professionals concerned in cancer care.

Methods Audio-recorded semi-structured interviews were transcribed verbatim and analysed thematically. Topics included perceptions of diagnosis; prognosis; future reproductive choices; priorities; quality of information received; communication and decisions made about future reproductive choices; and the role of partners, family, friends and healthcare professionals. Professional interviews examined their role in decision making and that of protocols and guidelines, together with information emerging from patient interview analysis.

Main outcome measure Themes identified following analysis of interview transcripts.

Results The primary barriers to pursuing fertility preservation were the way in which information was provided and the ‘urgent need for treatment’ conveyed by staff. Survival was always viewed as paramount, with future fertility secondary. Sperm banking was viewed as ‘part and parcel’ of oncology care, and the majority of men quickly stored sperm as ‘insurance’ against future infertility. Few women were afforded the opportunity to discuss their options, reflecting clinicians’ reservations about the experimental nature of egg and ovarian tissue cryopreservation, and the need for partner involvement in embryo storage.

Conclusions Significant gaps in the information provided to young women diagnosed with cancer suggest the need for an early appointment with a fertility expert.
Original languageEnglish
Pages (from-to)1049-1057
Number of pages9
JournalBJOG-An International Journal of Obstetrics and Gynaecology
Volume119
Issue number9
Early online date30 May 2012
DOIs
Publication statusPublished - Aug 2012

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Fertility Preservation
Decision Making
Interviews
Neoplasms
Fertility
Spermatozoa
Andrology
Cryopreservation
Hematology
Insurance
Germ Cells
Teaching Hospitals
Infertility
Ovum
Appointments and Schedules
Embryonic Structures
Communication
Outcome Assessment (Health Care)
Guidelines
Delivery of Health Care

Keywords

  • cancer
  • fertility preservation
  • qualitative

Cite this

Factors affecting decision making about fertility preservation after cancer diagnosis : A qualitative study. / Peddie, Valerie; Porter, Maureen Anne; Barbour, R.; Culligan, D.; MacDonald, G.; King, D.; Horn, J.; Bhattacharya, Siladitya.

In: BJOG-An International Journal of Obstetrics and Gynaecology, Vol. 119, No. 9, 08.2012, p. 1049-1057.

Research output: Contribution to journalArticle

Peddie, Valerie ; Porter, Maureen Anne ; Barbour, R. ; Culligan, D. ; MacDonald, G. ; King, D. ; Horn, J. ; Bhattacharya, Siladitya. / Factors affecting decision making about fertility preservation after cancer diagnosis : A qualitative study. In: BJOG-An International Journal of Obstetrics and Gynaecology. 2012 ; Vol. 119, No. 9. pp. 1049-1057.
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abstract = "Objective To increase our understanding of factors underlying the decision to store gametes after the diagnosis of cancer. Design Qualitative interview study. Setting Andrology, Haematology, and Oncology Departments of a Scottish teaching hospital, and patients’ own homes. Population Sixteen men and 18 women aged 17–49 years recently diagnosed with cancer; 15 health professionals concerned in cancer care. Methods Audio-recorded semi-structured interviews were transcribed verbatim and analysed thematically. Topics included perceptions of diagnosis; prognosis; future reproductive choices; priorities; quality of information received; communication and decisions made about future reproductive choices; and the role of partners, family, friends and healthcare professionals. Professional interviews examined their role in decision making and that of protocols and guidelines, together with information emerging from patient interview analysis. Main outcome measure Themes identified following analysis of interview transcripts. Results The primary barriers to pursuing fertility preservation were the way in which information was provided and the ‘urgent need for treatment’ conveyed by staff. Survival was always viewed as paramount, with future fertility secondary. Sperm banking was viewed as ‘part and parcel’ of oncology care, and the majority of men quickly stored sperm as ‘insurance’ against future infertility. Few women were afforded the opportunity to discuss their options, reflecting clinicians’ reservations about the experimental nature of egg and ovarian tissue cryopreservation, and the need for partner involvement in embryo storage. Conclusions Significant gaps in the information provided to young women diagnosed with cancer suggest the need for an early appointment with a fertility expert.",
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N2 - Objective To increase our understanding of factors underlying the decision to store gametes after the diagnosis of cancer. Design Qualitative interview study. Setting Andrology, Haematology, and Oncology Departments of a Scottish teaching hospital, and patients’ own homes. Population Sixteen men and 18 women aged 17–49 years recently diagnosed with cancer; 15 health professionals concerned in cancer care. Methods Audio-recorded semi-structured interviews were transcribed verbatim and analysed thematically. Topics included perceptions of diagnosis; prognosis; future reproductive choices; priorities; quality of information received; communication and decisions made about future reproductive choices; and the role of partners, family, friends and healthcare professionals. Professional interviews examined their role in decision making and that of protocols and guidelines, together with information emerging from patient interview analysis. Main outcome measure Themes identified following analysis of interview transcripts. Results The primary barriers to pursuing fertility preservation were the way in which information was provided and the ‘urgent need for treatment’ conveyed by staff. Survival was always viewed as paramount, with future fertility secondary. Sperm banking was viewed as ‘part and parcel’ of oncology care, and the majority of men quickly stored sperm as ‘insurance’ against future infertility. Few women were afforded the opportunity to discuss their options, reflecting clinicians’ reservations about the experimental nature of egg and ovarian tissue cryopreservation, and the need for partner involvement in embryo storage. Conclusions Significant gaps in the information provided to young women diagnosed with cancer suggest the need for an early appointment with a fertility expert.

AB - Objective To increase our understanding of factors underlying the decision to store gametes after the diagnosis of cancer. Design Qualitative interview study. Setting Andrology, Haematology, and Oncology Departments of a Scottish teaching hospital, and patients’ own homes. Population Sixteen men and 18 women aged 17–49 years recently diagnosed with cancer; 15 health professionals concerned in cancer care. Methods Audio-recorded semi-structured interviews were transcribed verbatim and analysed thematically. Topics included perceptions of diagnosis; prognosis; future reproductive choices; priorities; quality of information received; communication and decisions made about future reproductive choices; and the role of partners, family, friends and healthcare professionals. Professional interviews examined their role in decision making and that of protocols and guidelines, together with information emerging from patient interview analysis. Main outcome measure Themes identified following analysis of interview transcripts. Results The primary barriers to pursuing fertility preservation were the way in which information was provided and the ‘urgent need for treatment’ conveyed by staff. Survival was always viewed as paramount, with future fertility secondary. Sperm banking was viewed as ‘part and parcel’ of oncology care, and the majority of men quickly stored sperm as ‘insurance’ against future infertility. Few women were afforded the opportunity to discuss their options, reflecting clinicians’ reservations about the experimental nature of egg and ovarian tissue cryopreservation, and the need for partner involvement in embryo storage. Conclusions Significant gaps in the information provided to young women diagnosed with cancer suggest the need for an early appointment with a fertility expert.

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