Paediatric and adolescent fertility preservation procedural training and service provision: a qualitative study exploring views of clinicians in Australia and New Zealand

Background Remarkable progress in paediatric and adolescent fertility preservation (FP) has led to growing demand for services. However, best practice for gamete and gonadal tissue in paediatric and adolescent patients remains ill-defined. We explored the views of FP clinicians and laboratory staff on training needs for paediatric and adolescent FP procedures and services, the barriers across the FP pathway, and suggestions for improving service delivery. Methods Semi-structured interviews were conducted with multidisciplinary oncofertility experts from Australia and New Zealand. Data analysis of interview transcripts used the Framework Method. Results are reported with straight descriptions consistent with Qualitative Descriptive methods. Results Eighteen oncofertility clinicians and reproductive laboratory staff were interviewed. Paediatric surgeons viewed ovarian and testicular tissue harvesting within their scope of practice, though not gonadal tissue grafting. Education through direct observation and videos, and incorporation of oncofertility care into formalised surgical training programs was deemed important. Reproductive laboratory staff recommended that surgical training should include gonadal tissue harvesting techniques and guidance regarding adequate tissue volume removal. Reproductive laboratory staff requested bereavement training to better prepare them to support discussions with families. Oncofertility counselling and follow-up was not considered within scope of surgical practice by some surgeons and highlighted an unmet educational need by others. Conclusions As FP procedures become more widespread, building of a surgical and laboratory workforce with the skills to implement care is important. A multidisciplinary approach, supported by clear governance frameworks outlining roles, responsibilities and best practice before, during, and after FP procedures, is essential to delivering high-quality, coordinated care.

Journal of Pediatric Surgery

Journal of Pediatric Surgery

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1531-5037

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N/A

29