Clinical trial NCT06894810: Investigating the Efficacy of a Paediatric Fertility Preservation Decision Aid in Parents and Adolescents and Young Adults (CAYA) Cancer Survivors
Official title: A Double Blind Randomised Controlled Trial of a Paediatric Fertility Preservation Decision Aid in Parents and Adolescents and Young Adults (CAYA) Cancer Survivors
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Unmet Fertility Information Needs
Keywords: Fertility preservation
Child Adolescent and Young Adults
Decision Aid
CAYA
Cancer Survivors
Lead sponsor: Murdoch Childrens Research Institute
Sponsor class: OTHER
Collaborators: name: University of Melbourne
First posted: 2025-03-25
Enrollment: 358
Sex: ALL
Minimum age (years): 16
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: The current standard of care for paediatric patients with cancer regarding preservation of their fertility (FP) is to provide high-quality information during the clinical consultation process. However, this approach depends on health provider knowledge and communication and has been shown to be sub-optimal in some situations. This impairs the critical decision-making of patients regarding fertility testing, utilization of gametes, and continuing payment of storage fees. The fertility preservation decision aid (FP DA) may lead to a greater understanding of their fertility status for participants. This knowledge may allow participants the opportunity to assess potential fertility issues prior to the end of their reproductive window, helping to minimize missed opportunities for parenthood.

This research study aims to assess the effectiveness of the use of the FP DA on unmet fertility information needs when it is provided in addition to high-quality information in parents of cancer survivors and CAYA cancer survivors compared to high-quality information alone.

Detailed description: Medical advances over recent decades have increased the overall survival rates of children, adolescents and young adults diagnosed with cancer, with survival rates now exceeding 80%. The pressure points are not only at diagnosis - research has shown that cancer treatment can potentially affect fertility later in life. Survivorship is an important time for addressing the following issues: fertility status, reproductive monitoring, decisions about interval fertility preservation, ongoing tissue storage and utilization. Options to preserve fertility are possible. Decision Aids (DA) have been developed to provide patients and their families with the required information to make informed reproductive health decisions that align with their values. The prevalence of fertility information needs that are unmet remains high at around 40% amongst cancer survivors. Research evaluating the effectiveness of DAs in survivorship is lacking.

This is a parallel group double-blind randomised controlled trial for parents and Child Adolescent and Young Adults (CAYA) cancer survivors assessing the Fertility Preservation Decision Aid (FP DA) when provided in conjunction with high-quality information.

Eligible participants will be randomly allocated to either a control group receiving high-quality information or a treatment group that will receive the FP DA in addition to high-quality information. Participants will be blinded to their group allocation as they will be instructed to review information regarding fertility preservation without informing them of the type of information they are reviewing.

Eligibility criteria: Inclusion Criteria:

Inclusion Criteria for both parents and survivors:

* Be able to communicate in English.
* Signed written informed consent form.

Inclusion Criteria for parents only:

• Parents/guardians of CAYA survivors who were ≤25 years (2) when diagnosed with cancer and have completed curative gonadotoxic treatment

Inclusion Criteria for survivors only

* CAYA cancer survivors aged 16 years or over who have completed curative gonadotoxic treatment.
* Participants can be on long-term adjuvant or endocrine therapy.
* Participants may have achieved a pregnancy or livebirth.

Exclusion Criteria:

Exclusion Criteria for both parents and survivors:

* CAYA patients currently undergoing cancer treatment and their parents/guardians.
* CAYA patients who are palliative and their parents/guardians
* A family member already in the study.

Exclusion Criteria for survivors only:

• Minors who are not deemed to be mature minors as per protocol

Primary outcomes:
measure: Unmet information needs as measured by the Unmet Information Needs Scale within 4 weeks of randomisation
timeFrame: within 4 weeks randomisation
Secondary outcomes:
measure: Change in unmet fertility information needs as measured by questionnaire at 6 months post-randomisation
timeFrame: 6 months post-randomisation
measure: Change in fertility knowledge as measured using a purposively designed knowledge scale within 4 weeks of randomisation and at 6 months post-randomisation
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in decision making preparedness regarding fertility preservation measured by the Preparation for Decision Making Scale within 4 weeks of randomisation and at 6 months post-randomisation
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in decisional conflict as measured by the a validated decisional conflict scale within 4 weeks of randomisation and at 6 months post-randomisation
timeFrame: within 4 weeks and 6 months after randomisation
measure: Change in feasibility and acceptability of the information resources measured using a validated feasibility and acceptability scale within 4 weeks of randomisation and at 6 months post-randomisation
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- bounce rate
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- average session duration
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- average time on pages
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- pages view per visit
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- user behavior flow
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- exit rate
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- returning users
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- heatmap
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- individual page rating
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- the proportion of values clarification exercises completed
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
measure: Change in Fertility Preservation Decision Aid (FP DA) usage analytic- the responses to the exercises
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
Other outcomes:
measure: Changes in perceived usefulness of the information resources measured by a 5-item Decision Aid development scale at the time of diagnosis
timeFrame: within 4 weeks of randomisation, 6 months after randomisation
Locations:
city: Melbourne
country: Australia
facility: Murdoch Children's Research Institute
state: Victoria
Study officials:
References:
citation: McDougall RJ, Gillam L, Delany C, Jayasinghe Y. Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven? J Med Ethics. 2018 Jan;44(1):27-31. doi: 10.1136/medethics-2016-104042. Epub 2017 Oct 30.
citation: Turcotte S, Guerrier M, Labrecque M, Robitaille H, Rivest LP, Hess B, Legare F. Dyadic validity of the Decisional Conflict Scale: common patient/physician measures of patient uncertainty were identified. J Clin Epidemiol. 2015 Aug;68(8):920-7. doi: 10.1016/j.jclinepi.2015.03.005. Epub 2015 Mar 21.
citation: Lehmann V, Keim MC, Nahata L, Shultz EL, Klosky JL, Tuinman MA, Gerhardt CA. Fertility-related knowledge and reproductive goals in childhood cancer survivors: short communication. Hum Reprod. 2017 Nov 1;32(11):2250-2253. doi: 10.1093/humrep/dex297.
citation: Benedict C, Stal J, Davis A, Zeidman A, Pons D, Schapira L, Diefenbach M, Ford JS. Greater fertility distress and avoidance relate to poorer decision making about family building after cancer among adolescent and young adult female survivors. Psychooncology. 2023 Oct;32(10):1606-1615. doi: 10.1002/pon.6212. Epub 2023 Sep 11.