Views of male childhood cancer survivors on fertility preservation and restoration

Abstract

In this study, we aimed to uncover the perspectives of male childhood cancer survivors on parenthood, fertility preservation, and potential fertility restoration using their own cryopreserved testicular biopsy. We invited all young men eligible for this study, 27 male cancer survivors over the age of 16 who had undergone a testicular tissue biopsy in the past in Amsterdam, of whom five men (18.5% response rate) decided to participate. In semi-structured interviews, we discussed their views on parenthood, testicular cryopreservation, and potential fertility restoration, specifically through spermatogonial stem cell transplantation (SSCT). All data were pseudonymized before analysis via open coding using MAXQDA software. We found that all five participants (ages 17–24) had actively thought about family planning, and some expressed a very strong wish to experience parenthood, although they were aware of potential fertility issues related to their treatments. However, these participants reported that fertility issues had been minimally discussed at the late effects clinic during checkups, and they therefore had a limited understanding of the potential and restrictions of fertility restoration techniques such as SSCT. Overall, these participants displayed a high willingness to undertake additional steps to achieve biological parenthood and low levels of concern regarding the safety of SSCT. Autonomy and the opportunity of choice were determining factors in their underlying views. Perspectives and needs of these survivors, for whom a testicular biopsy was cryopreserved as a child, predominantly revolved around the importance of having autonomy over their fertility choices and being adequately informed to make those choices.