Predictors of Adolescent Sperm Banking: Development of a Profiling and Referral T

描述（由申请人提供）：尽管已知特定癌症治疗对生育能力有不良影响，但在美国，只有18-26%的高危青少年和年轻男性在癌症治疗前冷冻保存精子。对于那些在癌症诊断时焦虑加剧、年龄和社会经济地位较低、信仰福音派宗教或被诊断患有白血病/淋巴瘤的青少年来说，这些已经不理想的精子库比率甚至更低。目前尚不清楚为什么精子库没有得到充分利用，特别是考虑到儿童癌症幸存者对生育能力的高度重视以及与生育能力丧失相关的高度心理困扰。针对成年癌症患者精子库的研究表明，诸如医生沟通不畅以及患者缺乏生育风险知识等因素导致精子冷冻保存的频率较低。目前还没有设计良好的研究对癌症青少年中精子储存失败相关的风险因素进行调查，而癌症青少年是一个发育独特、适合干预的群体。我们建议确定预测精子库/非精子库的因素，以便设计干预措施，提高新诊断为癌症的青春期男性的生育能力。具体来说，我们的目的是调查心理、人口统计学、发育、父母/监护人、提供者和医学因素对高危癌症青少年精子库结果的预测。一旦这些因素被确定，我们将开发一种新的分析和转诊工具。该工具最终将通过促进适当的转诊和量身定制的干预措施来减少精子银行的障碍，从而成为卫生保健提供者和青少年的干预措施。最后，分析和转诊工具的可行性将根据提供者和患者的报告进行评估。

DESCRIPTION (provided by applicant): Despite the known adverse effects of specific cancer treatments on fertility, only 18-26% of at-risk adolescents and young men cryopreserve sperm prior to cancer treatment in the US. These already less than optimal rates of sperm banking are even lower among adolescents who have increased anxiety at cancer diagnosis, are lower in age and socioeconomic status, of Evangelical religious orientation, or are diagnosed with leukemia/lymphoma. It is not clear why sperm banking is underutilized, particularly in light of the high priority that survivors of childhood cancer place on fertility and the high psychological distress associated with fertility loss. Studies addressing sperm banking among adults with cancer suggest that factors such as poor physician communication and the resulting lack of fertility-risk knowledge by patients contributes to the low frequency of sperm cryopreservation. No well-designed studies have examined risk factors associated with failure to bank sperm among adolescents with cancer, a developmentally distinct population ripe for intervention. We propose to identify factors predictive of sperm banking/not sperm banking in order to design interventions for increasing fertility preservation among adolescent males newly diagnosed with cancer. Specifically, we aim to investigate psychological, demographic, developmental, parent/guardian, provider, and medical factors predictive of sperm banking outcomes among at-risk adolescents with cancer. Once these factors have been identified, we will develop a novel Profiling and Referral Tool. This instrument will ultimately serve as an intervention for both healthcare providers and adolescents through the facilitation of appropriate referrals, and tailored interventions for decreasing barriers to sperm banking. Finally, the feasibility of the Profiling and Referral tool will be evaluated based on provider and patient report. PUBLIC HEALTH RELEVANCE: Approximately 10% of adults in the US are affected by infertility-related distress. Knowledge gained from this study may prove to be useful in providing psychological interventions for this population.