title: Fertility Preservation in Pediatric and Adolescent Oncology Patients: The Decision-Making Process of Parents.
abstract: OBJECTIVE
  Decisions surrounding fertility preservation (FP) in children, adolescents, and adults can be difficult due to the distress of a cancer diagnosis, time constraints for decision-making, and lack of efficacy data. This review examines the decision-making process of oncology patients and their parents (if patients are in the pediatric or adolescent population) to better understand experiences of decisional conflict and regret.
  
  
  METHODS
  Two electronic databases, Embase and Pubmed, were searched using the terms (Decision-making OR Conflict (Psychology) OR Decision regret) AND (Freezing OR Oocyte OR Ovarian tissue OR Semen preservation OR Fertility preservation OR Cryopreservation) AND (Neoplasms OR Cancer OR Chemotherapy OR Drug therapy OR Radiotherapy). Medical Subject Heading terms were utilized where possible. Included articles discussed FP decision-making from the patient's perspective.
  
  
  RESULTS
  Thirty-five articles discussing FP decision-making were included (24 in the adult population, 11 in the pediatric and adolescent population). Key themes from these articles included the following: factors considered in FP decision-making, decision-making in established procedures and experimental procedures, decisional conflict and regret, the perceived importance of information, adolescent involvement in decision-making, and ethical considerations in the pediatric population.
  
  
  CONCLUSIONS
  Unique ethical issues arise in the pediatric and adolescent population. Considering that the decision to pursue FP is known to be difficult in the adult population, decisional conflict and regret may be greater for parents who are making the decision for their child.
authors.affiliation: 1 Department of Pediatrics, University of Melbourne , Melbourne, Victoria, Australia .|2 Department of Gynaecology, Royal Children's Hospital , Melbourne, Victoria, Australia .
authors.forename: Nancy
authors.initials: N
authors.lastname: Li
authors.affiliation: 1 Department of Pediatrics, University of Melbourne , Melbourne, Victoria, Australia .|2 Department of Gynaecology, Royal Children's Hospital , Melbourne, Victoria, Australia .|3 Department of Obstetrics & Gynaecology, Royal Women's Hospital, University of Melbourne , Melbourne, Victoria, Australia .
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Jayasinghe
authors.affiliation: 2 Department of Gynaecology, Royal Children's Hospital , Melbourne, Victoria, Australia .|3 Department of Obstetrics & Gynaecology, Royal Women's Hospital, University of Melbourne , Melbourne, Victoria, Australia .
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Kemertzis
authors.affiliation: 1 Department of Pediatrics, University of Melbourne , Melbourne, Victoria, Australia .|2 Department of Gynaecology, Royal Children's Hospital , Melbourne, Victoria, Australia .
authors.forename: Paddy
authors.initials: P
authors.lastname: Moore
authors.affiliation: 3 Department of Obstetrics & Gynaecology, Royal Women's Hospital, University of Melbourne , Melbourne, Victoria, Australia .
authors.forename: Michelle
authors.initials: M
authors.lastname: Peate
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003220:Conflict, Psychological; D003657:Decision Making; D004644:Emotions; D059247:Fertility Preservation; D006801:Humans; D008495:Medical Oncology; D009369:Neoplasms / Q000628:therapy*; D010290:Parents; D055815:Young Adult
keywords: fertility; oncofertility; pediatric; quality of life