So what can be learnt from this?

In reproductive medicine antibiotics shop in Canada online, information about the immediate and longerterm experience of participating in medical advances often lags behind the technology. This study aimed to begin to address the gap in research knowledge about the experiences of young men under the age of majority and their parents when offered fertility preservation following cancer diagnosis.

As a pilot study designed to test the feasibility of interviewing those affected, the sample size was intended to be fairly small. Although take up of the study was high, the number of interviews conducted was actually lower than anticipated because of the high relapse rate within this patient population. The findings from the interviews alone should therefore be treated with caution; until more research is available we cannot know how typical are the experiences reported here. However, there were similarities with the findings from other parts of the study (interviews with professionals and national postal surveys of practice in paediatric oncology and assisted conception) that warrant attention and that suggest that face-to-face interviews on this sensitive topic have the potential to offer valuable additional information in helping to shape the future direction of services. Both young men and parents showed high levels of recall of their experiences and there were very few discrepancies between accounts.

Although there may well be room for debate about the level of understanding that is deemed sufficient to indicate competence in making this decision, and about the adequacy of the existing legal provision, Gillick3 competence is currently a legal requirement for consent by minors in the UK, as are other aspects of the consent process. The lack of clarity among the young men and their parents about both consent to storage and consent to disclosure of information was perhaps due in part to the lack of clarity among some professionals. When combined with the relative lack of written and verbal information, their understanding of the impact on their fertility and sexuality may be unnecessarily limited.

The need to pay more attention to increasing the choices available at the time of decision-making, albeit within unavoidable constraints, is important. Assumptions about the appropriateness of how to involve mothers and fathers, when to raise it, how and where the sample should be produced and who should accompany the young man to the sperm bank are all areas where there is room for improved professional attention to increasing choices, maximizing feelings of control (at a time when feelings of loss of control may be particularly high) and meeting individual need in patients and parents at this difficult time. This is not about proscribing what should happen, it is about using professional skill in communication together with provision of appropriate information to try and ensure that the process works well for the individual and parents concerned.

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Offering greater choice does not mean abdicating responsibility for being proactive when appropriate. Respondents identified clear aspects of professional manner and communication that were valued highly, aided decision-making and made a difficult situation more manageable. These included directness and clarity in information giving, using warmth, and, on occasion, humour – and not being embarrassed.