Testicular tissue cryopreservation in prepubertal male children: an analysis of parental decision-making.
Testicular tissue cryopreservation in prepubertal male children: an analysis of parental decision-making.
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DOI：
10.1002/pbc.25078
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发表时间：
2014-09
影响因子：
3.2
通讯作者：
Kolon TF
中科院分区：
文献类型：
--
作者：
Ginsberg JP;Li Y;Carlson CA;Gracia CR;Hobbie WL;Miller VA;Mulhall J;Shnorhavorian M;Brinster RL;Kolon TF
不育是一个不幸的治疗相关的后果，一些儿科恶性肿瘤以及一些非恶性疾病治疗干细胞移植。与处于青春期的男性不同，处于青春期前的男性不能产生用于冷冻保存的精液。这份手稿报告的可接受性和安全性的多机构协议提供睾丸组织冷冻保存的家庭青春期前的男性儿童在不孕症的风险最高。数据的决策影响，决策控制，情绪状态时，考虑这个选项进行了说明。青春期前男性面临的性腺毒性治疗提供睾丸冷冻保存。活检后，随访患者的急性副作用。此外，父母和患者被要求完成问卷调查，无论他们是否选择冷冻保存组织。74个青春期前的男孩接近。57个家庭（77%）同意睾丸活检; 57人中有48人接受了手术。有一个术后副作用。父母谁同意睾丸冷冻保存和那些不觉得在这个决定的控制。同意活检和拒绝活检的父母并没有被该方案的实验性质所吓倒。一个重要的决策影响是活检的风险。三家机构成功且安全地对青春期前男性儿童的睾丸组织进行了活检和冷冻保存。在诊断时面临这种选择的父母可以做出明智的决定，并仔细权衡风险和利益。虽然父母在被诊断出一个困难的诊断后很快就被要求做出决定，但他们一致认为自己可以控制这个决定。
Infertility is an unfortunate treatment-related consequence for some pediatric malignancies as well as some non-malignant conditions treated with stem cell transplant. Unlike pubertal males, prepubertal males cannot produce semen for cryopreservation. This manuscript reports on the acceptability and safety of a multi-institutional protocol for offering testicular tissue cryopreservation to families of prepubertal male children at highest risk for infertility. Data on decision influences, decision-making control, and emotional state when considering this option are described. Prepubertal males facing gonadotoxic therapy were offered testicular cryopreservation. Post-biopsy, patients were followed for acute side effects. In addition, parents and patients were asked to complete questionnaires, whether or not they chose to cryopreserve tissue. Seventy-four prepubertal male children were approached. Fifty-seven families (77%) consented to the testicular biopsy; 48 of 57 underwent the procedure. There was one post-operative side effect. Parents who agreed to testicular cryopreservation and those that did not felt in control of this decision. Parents who consented to the biopsy and refusers were not deterred by the experimental nature of the protocol. An important decision-making influence was the risk of the biopsy. Biopsy and cryopreservation of testicular tissue from prepubertal male children was performed successfully and safely at three institutions. Parents faced with this option at diagnosis can make an informed decision and weigh carefully the risks and benefits. Although asked to make a decision soon after they were given a difficult diagnosis, parents uniformly felt in control of this decision.