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

Many couples face infertility and seek help for their unwanted childlessness. For men who are infertile because they do not ejaculate sperm cells, the only treatment option is surgically retrieving sperm cells from their testis (testicular sperm extraction, TESE) and this surgery, as well as the subsequent fertilization of an oocyte via intracytoplasmic sperm injection (ICSI), is often unsuccessful. Researchers are currently developing two alternative treatment options for these men involving stem cells. However, concerns have been raised on the need to define when new treatments can be tested on humans. The views of patients who will potentially undergo these treatments need to be heard regarding the new treatments being developed and on when they would be prepared to take part in new treatments. Therefore, this study explored patients' perspectives on current treatment (TESE-ICSI) and the two alternative treatment options by conducting in-depth interviews with 14 infertile men. Two researchers independently analysed the interview transcripts for common themes. Patients' appreciation of alternative treatment options depended on the effectiveness and safety of treatments but also on the intensity of the treatment procedure, the resemblance to natural conception and on feeling cured. Patients supported the development of the proposed new treatment options potentially enabling them to father a child and they were eager to take part in (research on) these alternative treatments. These findings can codirect research on these new treatment options. Moreover, this research is a first step towards incorporating patients' perspectives into defining when to introduce new technologies into clinical practice.