Perspectives and clinical practices on fertility preservation for young hematologic patients: a qualitative study of healthcare providers across multiple hospitals in China.

Abstract

Purpose: This study aims to understand healthcare providers' (HCPs) perspective and clinical practices regarding fertility preservation in young hematologic patients, particularly from hematology, reproductive medicine, and ethics committee professionals.

Methods: An empirical phenomenological approach was employed. HCPs were recruited from the hematology, reproductive medicine, and ethics committee professionals of eight tertiary hospitals in China using purposive sampling. They participated in semi-structured, in-depth face-to-face individual interviews. Interviews were transcribed verbatim and analyzed using Colaizzi's phenomenological method.

Results: A total of 33 HCPs were recruited, including 12 hematology physicians, two pediatric hematology physicians, six hematology nurses, nine reproductive medicine physicians, two reproductive medicine nurses, and two ethics committee members. The analysis revealed three major themes and associated subthemes: (1) HCPs' overall perspectives of fertility preservation: all recognized its importance and feasibility in young patients with hematologic diseases, though interdepartmental differences; (2) Fertility preservation practice status: still in its early stages, communication strategies are crucial, and balancing the urgency of disease treatment with fertility preservation remains a challenge; and (3) Multi-level challenges and recommendations: challenges exist across the medical system, patient-related factors, and sociocultural levels, with recommendations proposed to address some barriers.

Conclusions: HCPs recognized the importance and feasibility of fertility preservation for hematologic patients. However, its implementation faces challenges at multiple levels, including the medical system, patient-related factors, and sociocultural influences. To facilitate early discussions and informed decision-making about fertility preservation, it is crucial to enhance multidisciplinary collaboration, provide better support for patients and their families, and strengthen legal and policy frameworks.