Examining decisional needs and contextual factors influencing fertility status assessment among young female survivors of childhood cancer: A sequential mixed methods study protocol

• Authors: Anne Fitzpatrick, Emory University; Ann Mertens, Emory University; Jessica Spencer, Emory University; James Klosky, Emory University; Brooke Cherven, Emory University; NV Ivankova, University of Alabama Birmingham; KC Burns, University of Cincinnati; J Demedis, Childrens Hosp Colorado; HR Hoefgen, Childrens Healthcare Atlanta
• Journal Title: PLOS ONE
• Volume: Volume 18, Number 6
• Publisher: PUBLIC LIBRARY SCIENCE | 2023-06-14, Pages e0286511-e0286511
• Type of Work: Article
• Publisher DOI: http://doi.org/10.1371/journal.pone.0286511
• Keywords: Science & Technology; Multidisciplinary Sciences; Science & Technology - Other Topics; REPRODUCTIVE CONCERNS; INFERTILITY; PERCEPTIONS; ADULTHOOD; ADOLESCENCE; PREGNANCY; CONFLICT; CHILDREN; PROJECT

Abstract

Introduction Female cancer survivors who received gonadotoxic cancer treatment are at risk for profound diminished ovarian reserve and/or primary ovarian insufficiency with resulting infertility, which can be associated with distress and decreased quality of life.. Despite prioritizing future parenthood, many survivors are unsure of the impact of their treatment on their future fertility, and little is known about the perceived reproductive health needs and factors associated with receipt of a fertility status assessment (FSA). There is a lack of developmentally appropriate reproductive health decisional support interventions available for emerging adult cancer survivors. This study will explore the perceived reproductive health needs of emerging adult female survivors of childhood cancer and to identify decisional and contextual factors that influence pursuit of FSA using an explanatory sequential quantitative to qualitative mixed methods design. Methods and analysis This study will enroll 325 female survivors (aged 18 to 29 years and >1-year post treatment; diagnosed with cancer < age 21 years) from four cancer centers in the United States. Sociodemographic and developmental factors, reproductive knowledge and values, decisional needs, and receipt of an FSA will be assessed through a web-based survey. Informed by survey findings, a subset of participants will be recruited for qualitative interviews to explore decisional factors associated with uptake of an FSA. Clinical data will be abstracted from the medical records. Multivariable logistic regression models will be developed to identify factors associated with FSA and qualitative descriptive analysis will be used to develop themes from the interviews. Quantitative and qualitative findings will be merged using a joint display to develop integrated study conclusions and direct future interventional research.