Caregiver attitudes toward testicular tissue cryopreservation in prepubertal male cancer/HSCT patients A non-metropolitan, Canadian cohort.

INTRODUCTION

Prepubertal males undergoing cancer treatment or hematopoietic stem cell transplant (HSCT) are at risk of infertility but currently have no fertility preservation (FP) options. Immature testicular tissue cryopreservation (TTC) has been used for successful pregnancies/live births in animal models. Human TTC for experimental biobanking is currently being planned at select Canadian sites, with potential for expansion. Canadian patients/caregivers from metropolitan centers have previously demonstrated interest. To build an equitable national strategy, it is prudent to capture attitudes from caregivers from non-metropolitan sites. The aims of this study conducted in Saskatchewan were to describe the attitudes of caregivers of prepubertal male cancer/HSCT patients toward TTC and to measure caregiver willingness thresholds to consent to testicular biopsy for TTC.

METHODS

A questionnaire with demographic information, rank-order list regarding perceived barriers to TTC, and open-ended question was administered to caregivers of prepubertal cancer/HSCT patients at our tertiary pediatric hospital. An additional theoretical threshold setting exercise was conducted.

RESULTS

Fifty-two caregivers participated (response rate 85.2%; 73.5% female; age 37 years; 78% White; 18% Indigenous; all five income quintiles represented). Caregiver attitudes were child-focused (risk/benefit of procedure) rather than caregiver-focused (travel, cost.) On average, caregivers endorsed willingness to accept TTC in the setting of: minimum 26% chance of infertility from treatment; maximum 29% chance of biopsy complications; minimum 18% chance of future FP use; maximum $616 annual storage cost; and maximum 7.4 hours driving time.

CONCLUSIONS

Caregivers across Saskatchewan demonstrated interest in TTC. These results can inform efforts to expand TTC options and equitable access for prepubertal cancer/HSCT patients.