Male AYA Fertility Discussion: Engage the Patient

Home Echo Discussions Module 2 Discussion Male AYA Fertility Discussion: Engage the Patient

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    Several posts reflected my thoughts as I was watching this video, including the empathy conveyed by the social worker and her decision to focus on the present rather than the past. In addition to exploring the patient’s perspective about fertility and his reaction to learning about his fertility risk, I would have also tried engaging Jose to lead the discussion more by asking what questions he had and what he already knew about his fertility risk, as well as his level of interest in starting a family. This would have allowed me to tailor our discussion to include topics that were most salient to Jose, as opposed to potentially overwhelming him with education and information about all possible options. Finally, I would have periodically checked back with him to assess his understanding of each fertility option shared and to explore whether he believed it could be an option for him.


    I agree with you, on allowing space for him to explore the topics and feelings, letting him guide more of the conversation.


    Well said… the patient should have been given more of an opportunity to voice his feelings and thoughts on the advice provided by the social worker. I am hopeful this occurs when patients are in a counseling session there should be give and take rather than the counselor monopolizing the conversation. It is difficult when you are trying to give the patient a large amount of valuable information however this would be a good time to provide a pause in the conversation for the patient to feel comfortable to speak.


    I agree that he should be given an opportunity  to explore the topics and his feelings.  Allowing the patient time to express himself can actually enhance and provide more insight into the thought process of the patient about reproduction.


    I too had the same thoughts as I was watching the video. The clinician did a nice job summarizing potential family planning options. However, there was little opportunity for the patient to share his current feelings regarding potential for infertility and family planning options– for example is he looking to start a family soon? Is this something he wants to wait a few years to do or is he waiting until marriage? I also think it would be good for the clinician to know if he or is partner are currently using any birth control methods? And to help him explore how he may want to approach the potential for infertility and family planning options with his girlfriend.



    I agree with the previous responses – though the social worker is clearly knowledgeable about the topic and is attempting to provide the patient with a lot of information and resources,  she provided a great deal of information in one large chunk upfront, which could potentially be overwhelming for patients. I wonder what this conversation would have looked like if she had opened the conversation up to the patient and engaged him by asking him about his questions/concerns, as well as goals for the conversation. This may have helped to continue to build rapport, which may be helpful to have in future discussions.


    I agree 100%. I know the film tried to go over a lot of information quickly as an education tool, but it was a lot for anyone to process. Let alone an AYA male. They typically try their best to be stoic and engaging him more would help the whole team better understand his needs and where he is emotionally as he processes his fertility status/options.


    I agree that time should be allowed to consider the options and the conversations that are ahead for Jose and his girlfriend. An additional visit in the next week or so to discuss the issues again seems like an adequate way to give a patient that time.


    <span style=”color: #000000; font-family: Calibri;”>I agree that allowing for more time to explore his feelings around the issues is important. Young adolescents are concerned with serious relationships and have a capacity for tender and sensual love, yet they can also very well struggle to form close relationships and feel socially isolated. I think they are future oriented yet, struggle to still understand long term planning, the conversation can be very difficult. They can think through ideas, and express ideas, make independent decisions, however they still need emotional support. I think it is important to understand that the conversation needs to occur, and chronical age does not always equal developmental age. </span>


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