Fertility and assisted reproduction
Factors affecting decision making about fertility preservation after cancer diagnosis: a qualitative study
Article first published online: 30 MAY 2012
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 119, Issue 9, pages 1049–1057, August 2012
How to Cite
Peddie, V., Porter, M., Barbour, R., Culligan, D., MacDonald, G., King, D., Horn, J. and Bhattacharya, S. (2012), Factors affecting decision making about fertility preservation after cancer diagnosis: a qualitative study. BJOG: An International Journal of Obstetrics & Gynaecology, 119: 1049–1057. doi: 10.1111/j.1471-0528.2012.03368.x
- Issue published online: 10 JUL 2012
- Article first published online: 30 MAY 2012
- Accepted 6 February 2012. Published Online 30 May 2012.
- fertility preservation;
Please cite this paper as: Peddie V, Porter M, Barbour R, Culligan D, MacDonald G, King D, Horn J, Bhattacharya S. Factors affecting decision making about fertility preservation after cancer diagnosis: a qualitative study. BJOG 2012;119:1049–1057.
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.