Oncofertility in Prepubertal Girls: A Qualitative Study of Canadian and French Pediatric Oncologists’ Perspectives on Ovarian Tissue Cryopreservation
Bibliographic record
Abstract
BACKGROUND: It is now acknowledged that possible negative effects of cancer therapies on future reproductive autonomy are a major concern. In the bioethics literature, some advocate that the child's right to fertility preservation (FP) should be recognized as a right to an open future. RESEARCH OBJECTIVES: The aim of this qualitative study is to (1) explore pediatric oncologists' perceptions regarding barriers and facilitators of OTC in prepubertal girls and (2) analyze the ethical, legal, social, and policy implications of these barriers and facilitators in Canada and France. PARTICIPANTS AND RESEARCH DESIGN: Between November 2022 and August 2023, 10 French and 6 Canadian oncopediatricians took part in semi-directed interviews. The content of the interviews was analyzed using thematic content analysis. FINDINGS: All the participants emphasized the importance of FP, describing it as a fundamental right and central part of care. However, they identified ethical issues associated with the cost and the uncertainties of ovarian tissue cryopreservation (OTC). The majority thought that OTC should be covered by the public healthcare system to promote equity of access. French oncopediatricians of this study considered OTC to be standard of care, while the majority of Canadian oncopediatricians still considered it experimental, due to the risk of reintroducing malignant cells. DISCUSSION/CONCLUSIONS: The results highlight the importance of FP for prepubertal girls as a right, linked to the child's right to an open future, as described in bioethics literature. According to these findings, the fact that OTC is not systematically discussed, offered, or not covered by the healthcare system constitutes a barrier and fails to protect patients, who may experience future infertility as a consequence of their treatment, thus curtailing their reproductive autonomy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.021 | 0.012 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".