Fertility preservation needs of men undergoing cancer treatment:  An explorative qualitative study

Introduction Developing timely, adequate informational and emotional support to help patients make informed decisions about fertility preservation (FP) is an ongoing challenge. Men undergoing cancer treatment face risks to their fertility which, if not effectively managed, may adversely affect their quality-of-life post-treatment. Research indicates that while they are regularly advised or encouraged to pursue FP, men often receive insufficient information about it. Despite the extensive literature on cancer patient support, the informational needs of men as they relate to FP have been largely unaddressed. Method We used a qualitative secondary analysis of a subset of data from a larger study of clinicians’ perspectives and experiences of FP, as well as women and men’s experiences of cancer and FP, and a thematic analysis approach to answer the question, what are men’s unmet informational and emotional needs related to the FP process and what are the challenges and tensions inherent in meeting them? Findings Participants were 12 men, > 18 who had undergone fertility-threatening cancer treatments for a malignancy within the previous 5 years and who faced onco-fertility decisions before cancer treatments. Men experienced unmet support needs. They received neither enough emotional nor enough informational support to make fully informed decisions, and they experienced FP decisions as directives rather than as informed deliberations. They needed different kinds and amounts of information at different stages of their illness journey. Logistics, physiological and psychological challenges impeded meeting these needs. Conclusions Right sizing FP information in the context of cancer diagnoses continues to be a challenge. This preliminary exploration of the unmet FP needs of men diagnosed with cancer is a useful first step to inform resource development related to counselling men who face threats to their fertility via cancer treatments. Implications Given the potentially negative effects on quality of survivorship when FP issues are not effectively addressed, it is crucial that men’s fertility management go beyond advising the pursuit of FP to provision of resources necessary to do so. These findings can serve as a springboard for further research and discussions of such goals.