Perspectives of infertile men on future stem cell treatments for nonobstructive azoospermia

Abstract

Concerns have been expressed about the rapid introduction of new fertility treatments into clinical practice. Patients' perspectives on new treatments and their introduction into clinical practice are unexplored. Two alternative treatments for testicular sperm extraction followed by intracytoplasmic sperm injection in men with nonobstructive azoospermia (NOA), the formation of artificial sperm and autotransplantation of in vitro proliferated spermatogonial stem cells, are in a preclinical phase of development. This study aimed to explore, prior to future clinical introduction, which treatment aspects are valued by NOA patients and would be taken into account in deciding to undergo these future treatment options. In-depth telephone interviews were conducted with 14 men with NOA. Interviews were transcribed, analysed with content analysis and data saturation was reached. Besides the obvious factors, success rates and safety, patients valued 'the intensity of the procedure', 'the treatments' resemblance to natural conception' and 'feeling cured'. Patients supported the development of these treatments and were eager to take part if such treatments would become available in the future. The patient's perspective on innovative treatments can (co)direct reproductive research. More research into the patients' perspectives on innovations and minimal thresholds to be met prior to their introduction into clinical practice is required.

Keywords: TESE; artificial gametes; assisted reproductive technologies; male infertility; patient centredness; spermatogonial stem cells.