Perceptions of Infertility Risk Among Chinese Parents of Children with Cancer: A Qualitative Study.

Abstract

Objective: Anticancer treatment may be associated with damage to the reproductive organs and risk of infertility in children with cancer. The collectivist cultural norms of Asian societies may lead Chinese parents to have unique concerns regarding infertility. This qualitative study explored the perceptions of infertility risk and parenthood among parents of childhood cancer survivors in Hong Kong. Methods: Thirteen parents were recruited via a snowball sampling approach from a nongovernmental organization in Hong Kong, representing nine survivors of childhood cancer (leukemia n\u2009=\u20095, solid tumors n\u2009=\u20094). The in-depth semistructured interviews were audiotaped and transcribed verbatim. A thematic analysis was performed using ATLAS.ti 8. Results: Parents mostly perceived their children s fertility status as a distant concern (n\u2009=\u200911, 85%) but emphasized the need for timely information from clinicians when their children reach young adulthood (n\u2009=\u20098, 62%). They reported receiving inconsistent fertility information from different oncology practitioners (n\u2009=\u20099, 69%). A few parents acknowledged that under the influence of the Chinese culture, their children, especially sons, have an important duty to continue the family lineage. However, even if the cancer treatment were associated with infertility risk, almost all parents (n\u2009=\u200912, 92%) stated that it would still not affect their willingness to let their child undergo treatment because survival and cure were still their highest priority. Conclusion: Our findings suggest the need to proactively provide fertility information to parents both during active treatment and when survivors reach reproductive age. Future studies should evaluate the benefits of developing culturally relevant decision-making aids to address parents informational needs regarding fertility issues.